Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing

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Abstract

Background
hypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer’s disease pathology.

Objective
to examine relationships between blood pressure (BP) components and brain pathology in older adults.

Subjects
two hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years.

Methods
BP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships.

Results
higher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = −0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = −0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011).

Conclusion
increased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer’s diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.
Original languageEnglish
Pages (from-to)95-100
Number of pages6
JournalAge and Ageing
Volume47
Issue number1
Early online date4 Jul 2017
DOIs
Publication statusPublished - 1 Jan 2018

Fingerprint

Dementia
Biomarkers
Magnetic Resonance Imaging
Pathology
Blood Pressure
Brain
Cerebrovascular Disorders
Hippocampus
Alzheimer Disease
Antihypertensive Agents
Parturition
Hypertension

Keywords

  • systolic
  • diastolic
  • variability
  • hyperintensities
  • hippocampus

Cite this

@article{6f8c9c31d14547ff91f8ebb94b9eba57,
title = "Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing",
abstract = "Backgroundhypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer’s disease pathology.Objectiveto examine relationships between blood pressure (BP) components and brain pathology in older adults.Subjectstwo hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years.MethodsBP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships.Resultshigher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = −0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = −0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011).Conclusionincreased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer’s diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.",
keywords = "systolic, diastolic, variability, hyperintensities, hippocampus",
author = "McNeil, {Christopher J.} and Myint, {Phyo Kyaw} and Anca-Larisa Sandu-Giuraniuc and Potter, {John F.} and Roger Staff and Whalley, {Lawrence J.} and Murray, {Alison D.}",
note = "Sources of Funding This work was supported by Alzheimer's Research Trust (now Alzheimer's Research UK) and the University of Aberdeen Development Trust. Acknowledgements We gratefully acknowledge the contribution of participants of the Aberdeen 1936 Birth cohort who have willingly given their time to participate.",
year = "2018",
month = "1",
day = "1",
doi = "10.1093/ageing/afx102",
language = "English",
volume = "47",
pages = "95--100",
journal = "Age and Ageing",
issn = "0002-0729",
publisher = "OXFORD UNIV PRESS INC",
number = "1",

}

TY - JOUR

T1 - Increased diastolic blood pressure is associated with MRI biomarkers of dementia-related brain pathology in normative ageing

AU - McNeil, Christopher J.

AU - Myint, Phyo Kyaw

AU - Sandu-Giuraniuc, Anca-Larisa

AU - Potter, John F.

AU - Staff, Roger

AU - Whalley, Lawrence J.

AU - Murray, Alison D.

N1 - Sources of Funding This work was supported by Alzheimer's Research Trust (now Alzheimer's Research UK) and the University of Aberdeen Development Trust. Acknowledgements We gratefully acknowledge the contribution of participants of the Aberdeen 1936 Birth cohort who have willingly given their time to participate.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Backgroundhypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer’s disease pathology.Objectiveto examine relationships between blood pressure (BP) components and brain pathology in older adults.Subjectstwo hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years.MethodsBP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships.Resultshigher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = −0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = −0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011).Conclusionincreased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer’s diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.

AB - Backgroundhypertension is a risk for brain ageing, but the mechanisms underlying this effect remain unclear. Magnetic resonance imaging (MRI) detected biomarkers of brain ageing include white matter hyperintensities (WMHs), a marker of cerebrovascular disease, and hippocampal volume, a marker of Alzheimer’s disease pathology.Objectiveto examine relationships between blood pressure (BP) components and brain pathology in older adults.Subjectstwo hundred and twenty-seven members of the Aberdeen 1936 Birth Cohort between ages 64 and 68 years.MethodsBP was assessed biennially between 64 and 68 years and brain MRI performed at 68 years. The risk factors of interest were diastolic and systolic BP and their visit-to-visit variability. Outcomes were WMH abundance and hippocampal volume. Regression models, controlling for confounding factors, examined their relationships.Resultshigher diastolic BP predicted increased WMH (β = 0.13, P = 0.044) and smaller hippocampi (β = −0.25, P = 0.006). In contrast, increased systolic BP predicted larger hippocampi (β = 0.22, P = 0.013). Variability of diastolic BP predicted lower hippocampal volume (β = −0.15, P = 0.033). These relationships were independent of confounding life-course risk factors. Anti-hypertensive medication did not modify these relationships, but was independently associated with increased WMH (β = 0.17, P = 0.011).Conclusionincreased diastolic BP is associated with biomarkers of both cerebrovascular and Alzheimer’s diseases, whereas the role of systolic BP is less clear, with evidence for a protective effect on hippocampal volume. These differing relationships emphasise the importance of considering individual BP components with regard to brain ageing and pathology. Interventions targeting diastolic hypertension and its chronic variability may provide new strategies able to slow the accumulation of these harmful pathologies.

KW - systolic

KW - diastolic

KW - variability

KW - hyperintensities

KW - hippocampus

U2 - 10.1093/ageing/afx102

DO - 10.1093/ageing/afx102

M3 - Article

C2 - 29106439

VL - 47

SP - 95

EP - 100

JO - Age and Ageing

JF - Age and Ageing

SN - 0002-0729

IS - 1

ER -