Increased blood pressure variability, particularly systolic long-term and night-time BPV, was associated with lower whole brain and hippocampal volumes.
Systematic Review (n=20)
Is increased blood pressure variability associated with structural brain changes assessed by MRI?
Increased long-term and night-time systolic blood pressure variability is associated with lower brain and hippocampal volumes, suggesting a structural mechanism for BPV-related cognitive decline.
BACKGROUND: Blood pressure variability (BPV) has been linked with cognitive impairment and dementia. However, the pathophysiological mechanisms by which BPV affects cognition are unclear. This systematic review aims to assess the links between different BPV measures and white and grey matter structures. METHODS AND RESULTS: The following databases were searched from inception through to January 2021; EMBASE, MEDLINE, EMCARE and SCOPUS. Studies that reported on the relationship between within-individual BPV (short, medium or long-term variability) or a circadian blood pressure (BP) measurement and MRI assessed brain structures were included. Overall, 20 studies met the criteria and were included, of which 11 studies looked at short-term BPV, eight articles investigated visit-to-visit BPV and one study looked at a compositional BPV measurement. Due to heterogeneity in study samples, meta-analysis was not possible. Across the included studies, associations between MRI indices and BP dipping patterns were mixed; higher long-term BPV and higher sleep systolic BPV was found to be associated with lower whole brain volume and hippocampal volume. CONCLUSION: Increased BPV, in particular systolic long-term and systolic night-time BPV, appears to be associated with lower brain volume and hippocampal volume. This highlights the adverse effect that increased BPV has upon the brain, potentially contributing to cognitive decline, including dementia, in late-life.
Gutteridge et al. (Wed,) conducted a systematic review in Structural brain changes (n=20). Blood pressure variability (BPV) was evaluated on MRI assessed brain structures (white and grey matter structures). Increased blood pressure variability, particularly systolic long-term and night-time BPV, was associated with lower whole brain and hippocampal volumes.