Key result
Hypertension and longer disease duration were associated with smaller brain volumes, larger white matter hyperintensities, and poorer cognitive performance compared with normotensives.
Why the study?
Previous studies linking hypertension to brain atrophy and poorer cognitive performance often had small older cohorts lacking multiple hypertension measures, and the impact of hypertension duration remained less extensively studied.
Is hypertension and its duration associated with reduced brain volumes and poorer cognitive performance?
Cross-Sectional (n=31,513)
Is hypertension and its duration associated with reduced brain volumes and poorer cognitive performance?
Hypertension and its duration are significantly associated with adverse structural brain changes and poorer cognitive performance.
May support BP monitoring in Alzheimer disease; leaves open causal effects on progression.
BACKGROUND: Mid-life hypertension is an established risk factor for cognitive impairment and dementia and related to greater brain atrophy and poorer cognitive performance. Previous studies often have small sample sizes from older populations that lack utilizing multiple measures to define hypertension such as blood pressure, self-report information, and medication use; furthermore, the impact of the duration of hypertension is less extensively studied. OBJECTIVE: To investigate the relationship between hypertension defined using multiple measures and length of hypertension with brain measure and cognition. METHODS: Using participants from the UK Biobank MRI visit with blood pressure measurements (n = 31,513), we examined the cross-sectional relationships between hypertension and duration of hypertension with brain volumes and cognitive tests using generalized linear models adjusted for confounding. RESULTS: Compared with normotensives, hypertensive participants had smaller brain volumes, larger white matter hyperintensities (WMH), and poorer performance on cognitive tests. For total brain, total grey, and hippocampal volumes, those with greatest duration of hypertension had the smallest brain volumes and the largest WMH, ventricular cerebrospinal fluid volumes. For other subcortical and white matter microstructural regions, there was no clear relationship. There were no significant associations between duration of hypertension and cognitive tests. CONCLUSION: Our results show hypertension is associated with poorer brain and cognitive health however, the impact of duration since diagnosis warrants further investigation. This work adds further insights by using multiple measures defining hypertension and analysis on duration of hypertension which is a substantial advance on prior analyses-particularly those in UK Biobank which present otherwise similar analyses on smaller subsets.
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Newby et al. (2021) conducted a cross-sectional in Hypertension (n=31,513). Hypertension vs. Normotensives was evaluated on Brain volumes, white matter hyperintensities, and cognitive test performance. Hypertension and longer disease duration were associated with smaller brain volumes, larger white matter hyperintensities, and poorer cognitive performance compared with normotensives.
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