Key result
Treated isolated systolic hypertension is linked to smaller total gray matter volume vs normotension.
Why the study?
The relationship between isolated hypertension and brain health, including its comparison with systolic-diastolic hypertension, remains relatively unknown despite its increased prevalence.
Does isolated hypertension impact global and regional brain volumes compared to normal blood pressure or systolic-diastolic hypertension in healthy midlife and older adults?
Cross-Sectional (n=29,775)
Yes
Does isolated hypertension impact global and regional brain volumes compared to normal blood pressure or systolic-diastolic hypertension in healthy midlife and older adults?
Standardized Mean Difference: -0.04 (95% CI -0.06–-0.02)
p-value: p=<0.05
Isolated hypertension, even when treated, is associated with markers of adverse brain health such as brain atrophy and white matter hyperintensities compared to normotensive states, emphasizing the cognitive impact of elevated blood pressure.
Should not yet change practice; leaves open causal effects of treated isolated systolic hypertension on brain volumes in cross-sectional data.
BACKGROUND: Hypertension is a well-established risk factor for cognitive impairment, brain atrophy, and dementia. However, the relationship of other types of hypertensions, such as isolated hypertension on brain health and its comparison to systolic-diastolic hypertension (where systolic and diastolic measures are high), is still relatively unknown. Due to its increased prevalence, it is important to investigate the impact of isolated hypertension to help understand its potential impact on cognitive decline and future dementia risk. In this study, we compared a variety of global brain measures between participants with isolated hypertension to those with normal blood pressure (BP) or systolic-diastolic hypertension using the largest cohort of healthy individuals. METHODS: Using the UK Biobank cohort, we carried out a cross-sectional study using 29,775 participants (mean age 63 years, 53% female) with BP measurements and brain magnetic resonance imaging (MRI) data. We used linear regression models adjusted for multiple confounders to compare a variety of global, subcortical, and white matter brain measures. We compared participants with either isolated systolic or diastolic hypertension with normotensives and then with participants with systolic-diastolic hypertension. RESULTS: The results showed that participants with isolated systolic or diastolic hypertension taking BP medications had smaller gray matter but larger white matter microstructures and macrostructures compared to normotensives. Isolated systolic hypertensives had larger total gray matter and smaller white matter traits when comparing these regions with participants with systolic-diastolic hypertension. CONCLUSIONS: These results provide support to investigate possible preventative strategies that target isolated hypertension as well as systolic-diastolic hypertension to maintain brain health and/or reduce dementia risk earlier in life particularly in white matter regions.
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Newby et al. (2022) conducted a cross-sectional in Isolated hypertension (n=29,775). Isolated systolic hypertension (taking BP medications) vs. Normotensive participants (not taking BP medications) was evaluated on Total gray matter volume (standardized β -0.04, 95% CI -0.06 to -0.02, p=<0.05). Isolated systolic hypertension taking blood pressure medications was associated with smaller total gray matter volumes compared to normotensive individuals (standardized β -0.04).
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