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Blood pressure variability and white matter hyperintensities in older adults with cardiovascular disease

John Gunstad1, Ronald A Cohen, David F Tate

  • 1Kent State University, Kent, Ohio.

Blood Pressure
|January 13, 2006
PubMed

Insights

Blood pressure variability, not just average readings, is linked to white matter hyperintensities (WMH) in older adults with cardiovascular disease (CVD). This suggests BP variability plays a key role in brain changes.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • White matter hyperintensities (WMH) are common in older adults and associated with cognitive decline.
  • Cardiovascular disease (CVD) is a known risk factor for cerebrovascular damage, including WMH.
  • The specific relationship between various blood pressure (BP) indices and WMH in CVD patients remains incompletely understood.

Purpose of the Study:

  • To investigate the association between different blood pressure (BP) indices and white matter hyperintensities (WMH) in older adults with cardiovascular disease (CVD).
  • To determine if BP variability or specific BP measures are more strongly related to WMH burden in different brain regions.

Main Methods:

  • 39 older adults with CVD underwent 2-hour resting BP monitoring.
  • WMH were quantified using FLAIR MRI, with regional indices calculated for neocortical, periventricular, and subcortical areas.
  • Correlation and regression analyses were performed to assess relationships between BP indices and WMH.

Main Results:

  • Systolic BP variability correlated with neocortical and total WMH.
  • A composite index of systolic BP variability and average diastolic pressure showed the strongest associations with neocortical, subcortical, and total WMH.
  • No significant relationships were found between any BP index and periventricular WMH.
  • Exploratory analyses indicated that the composite BP index, but not age, CVD conditions, or psychosocial factors, predicted total WMH.

Conclusions:

  • Blood pressure variability is a significant contributor to WMH in older adults with CVD.
  • The relationship between BP variability and WMH may differ across distinct brain regions.
  • Further research, potentially using beat-to-beat BP monitoring, is warranted to elucidate the role of autoregulatory systems in WMH development.

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