Hypertension Trends and White Matter Brain Injury in the Offspring Framingham Heart Study Cohort

医学 心脏病学 内科学 血压 弗雷明翰风险评分 部分各向异性 高强度 弗雷明翰心脏研究 队列 白质 冲程(发动机) 磁共振成像 疾病 机械工程 放射科 工程类
作者
Rodica E. Petrea,Adlin Pinheiro,Serkalem Demissie,Oluchi Ekenze,Hugo J. Aparicio,Claudia L. Satizabal,Pauline Maillard,Charles DeCarli,Alexa Beiser,Sudha Seshadri,Vasileios‐Arsenios Lioutas,José R. Romero
出处
期刊:Hypertension [Lippincott Williams & Wilkins]
卷期号:81 (1): 87-95
标识
DOI:10.1161/hypertensionaha.123.21264
摘要

Hypertension is the most potent stroke risk factor and is also related to cerebral small vessel disease. We studied the relation between mid-to-late-life hypertension trends and cerebral white matter injury in community-dwelling individuals from the FHS (Framingham Heart Study).FHS Offspring cohort participants with available mid-life and late-life blood pressure measurements and brain magnetic resonance imaging were included. Multiple regression analyses were used to relate hypertension trends (normotension-normotension [reference], normotension-hypertension, and hypertension-hypertension) to white matter injury metrics on diffusion tensor imaging (free water, fractional anisotropy, and peak skeletonized mean diffusivity) and Fluid Attenuated Inversion Recovery (white matter hyperintensity volume) by different blood pressure cutoffs (130/80, 140/90, and 150/90 mm Hg).We included 1018 participants (mean age 47.3±7.4 years at mid-life and 73.2±7.3 at late-life). At the 140/90 mm Hg cutoff, the hypertension-hypertension trend was associated with higher free water (β, 0.16 [95% CI, 0.03-0.30]; P=0.021) and peak skeletonized mean diffusivity (β, 0.15 [95% CI, 0.01-0.29]; P=0.033). At a 130/80 mm Hg cutoff, the hypertension-hypertension trend had significantly higher free water (β, 0.16 [95% CI, 0.01-0.30]; P=0.035); and the normotension-hypertension (β, 0.24 [95% CI, 0.03-0.44]; P=0.027) and hypertension-hypertension (β, 0.22 [95% CI, 0.04-0.41]; P=0.022) trends had significantly increased white matter hyperintensity volume. Exploratory stratified analysis showed effect modifications by APOE ɛ4 allele and age.Mid-to-late-life hypertension exposure is significantly associated with microstructural and to a lesser extent, visible white matter injury; the effects are observed at both conventional and lower blood pressure cutoffs and are associated with longer duration of hypertension.
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