Associations of Brain Morphology and Cognitive Function With Ambulatory Estimated Pulse Wave Velocity

BACKGROUND: Inconsistent links between arterial stiffness and cognition may reflect limited cognitive tests and unaccounted diurnal pulse wave velocity variation. To bridge this knowledge gap, we investigated 24-hour ambulatory estimated pulse wave velocity (ePWV) and its association with dementia-related neuroimaging and cognitive function in hypertension. METHODS: We assessed 893 patients with hypertension aged ≥50 years (mean age, 67.2 years; 52.3% women), including brain magnetic resonance imaging (n=545), global cognitive testing (n=623), and ambulatory ePWV measurements. White matter hyperintensity and hippocampus were quantified via Computational Anatomy Toolbox 12 and Statistical Parametric Maps 12. Cognition was assessed via the Mini-Mental State Examination and Montreal Cognitive Assessment. RESULTS: ≥0.18). Results were consistent for daytime and nighttime ePWV and across key subgroups. CONCLUSIONS: Ambulatory ePWV is an independent risk factor for dementia-related brain pathology. Targeting arterial stiffness represents a promising strategy for dementia prevention.