Do life-course blood pressure patterns affect late-life brain volumes in adults?
Hypertension 15 to 24 years prior, and particularly hypertension followed by late-life hypotension, is associated with smaller late-life brain volumes.
INTRODUCTION: The impact of blood pressure on brain volumes may be time-dependent or pattern-dependent. METHODS: Of 1678 participants from the Atherosclerosis Risk in Communities Neurocognitive Study, we quantified the association between measures and patterns of blood pressure over three time points (∼24 or ∼15 years prior and concurrent with neuroimaging) with late life brain volumes. RESULTS: Higher diastolic blood pressure ∼24 years prior, higher systolic and pulse pressure ∼15 years prior, and consistently elevated or rising systolic blood pressure from ∼15 years prior to concurrent with neuroimaging, but not blood pressures measured concurrent with neuroimaging, were associated with smaller volumes. The pattern of hypertension ∼15 years prior and hypotension concurrent with neuroimaging was associated with smaller volumes in regions preferentially affected by Alzheimer's disease (e.g., hippocampus: -0.27 standard units, 95% CI: -0.51, -0.03). DISCUSSION: Hypertension 15 to 24 years prior is relevant to current brain volumes. Hypertension followed by hypotension appears particularly detrimental.
Power et al. (2016) studied this question.