Lower Blood Pressure and Gray Matter Integrity Loss in Older Persons

Area of Science:

• Neurology
• Gerontology
• Cardiovascular Science

Background:

• Cerebral small vessel disease (cSVD) is common in older adults.
• The relationship between blood pressure (BP) and cSVD in the elderly is not well understood.
• Previous research focused on BP's association with cSVD in middle-aged individuals.

Purpose of the Study:

• To investigate the association between BP and cSVD in individuals aged 75 and older.
• To examine the relationship between BP and gray and white matter integrity in older persons.
• To determine if lower BP thresholds are associated with adverse brain changes in the elderly.

Main Methods:

• Utilized data from 220 participants aged 75+ in the Discontinuation of Antihypertensive Treatment in the Elderly (DANTE) study.
• Assessed cSVD using conventional magnetic resonance imaging (MRI).
• Evaluated microstructural integrity via diffusion tensor imaging (DTI) and magnetization transfer (MT) imaging.

Main Results:

• No significant association was found between BP measures and cSVD.
• Lower systolic BP, diastolic BP, and mean arterial pressure correlated with decreased gray matter MT ratio peak height and MT ratio in cortical gray matter.
• Mean arterial pressure was also associated with increased gray matter diffusivity, indicating worse gray matter integrity.

Conclusions:

• BP is not associated with cSVD in older individuals.
• Lower BP levels are linked to diminished gray matter integrity in the elderly.
• Current upper BP thresholds may need reevaluation, with consideration for lower BP thresholds in older populations.