Progression of white matter hyperintensities is related to blood pressure increases and global cognitive decline – A registered report

Abstract

White matter hyperintensities (WMH) reflect cerebral small vessel disease (cSVD), a major brain pathology contributing to cognitive decline and dementia. Vascular risk factors, including higher diastolic blood pressure (DBP), have been associated with the progression of WMH yet longitudinal studies have not comprehensively assessed these effects for abdominal obesity or reported sex/gender-specific effects. In this pre-registered analysis of a longitudinal population-based neuroimaging cohort, we investigated the association of baseline DBP and waist-to-hip ratio with WMH progression in linear mixed models. We also examined the relationship of WMH progression and executive and global cognitive function. We conducted gender interaction and stratified analyses. We included data from 596 individuals (44.1 % females, mean age = 63.2 years) with two MRI scans over approximately 6 years. We did not find a significant association of baseline DBP with WMH progression. WMH progression significantly predicted global cognitive decline but not decline in executive function. In exploratory analyses, increases in DBP as well as baseline and increase in systolic blood pressure were associated with WMH progression, confined to frontal periventricular regions. There was no association of WHR nor any gender-specific associations with WMH progression. Adequate BP control might contribute to limit WMH progression and negative effects on global cognitive function in the middle-aged to older population for men and women.