Key result
Higher DBP and MAP are linked to reduced brain volume and increased white matter lesions.
Why the study?
The association between blood pressure across its full range and brain volumes and white matter lesions, including effects of age, sex, BMI, and antihypertensive medication, was not fully quantified.
Does higher blood pressure reduce brain volumes and increase white matter lesions in adults aged 40-70 years?
Observational (n=36,260)
Does higher blood pressure reduce brain volumes and increase white matter lesions in adults aged 40-70 years?
Higher blood pressure is associated with worse cerebral health, including lower brain volumes and increased white matter lesions, detectable from middle adulthood.
Higher BP across its range may signal cerebral risk from middle age; leaves open whether early control preserves volumes in normotensives.
Background: To quantify the association between blood pressure (BP) across its full range, brain volumes and white matter lesions (WMLs) while investigating the effects of age, sex, body mass index (BMI), and antihypertensive medication. Methods: UK Biobank participants (n = 36,260) aged (40−70) years were included and stratified by sex and four age groups (age ≤ 45, 46−55, 56−65 and > 65 years). Multi-level regression analyses were used to assess the association between mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), and brain volumes segmented using the FreeSufer software (gray matter volume [GMV], white matter volume [WMV], left [LHCV] and right hippocampal volume [RHCV]) and WMLs. Interaction effects between body mass index (BMI), antihypertensive medication and BP in predicting brain volumes and WMLs were also investigated. Results: Every 10 mmHg higher DBP was associated with lower brain volumes (GMV: −0.19%−−0.40%) [SE = 47.7−62.4]; WMV: −0.20−−0.23% [SE = 34.66−53.03]; LHCV: −0.40−−0.59% [SE = 0.44−0.57]; RHCV: −0.17−−0.57% [SE = 0.32−0.95]) across all age groups. A similar pattern was detected in both sexes, although it was weaker in men. Every 10 mmHg higher MAP was associated with larger WMLs across all age groups but peaked >65 years (1.19−1.23% [SE = 0.002]). Both lower BMI and anti-hypertensive medication appeared to afford a protective effect. Conclusion: Higher BP is associated with worse cerebral health across the full BP range from middle adulthood and into old age.
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Alateeq et al. (2022) reported an observational. Higher blood pressure vs. Lower blood pressure was evaluated on Brain volumes (gray matter, white matter, hippocampal) and white matter lesions. Every 10 mmHg higher diastolic blood pressure was associated with lower brain volumes, and higher mean arterial pressure was associated with larger white matter lesions across all age groups.
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