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Blood pressure-related differences in brain health between young African Americans and Caucasian Americans
Junyeon Won1, Sushant M Ranadive1, Daniel D Callow1,2
1Department of Kinesiology, University of Maryland, College Park, MD, USA.
Insights
Younger African Americans (AAs) show decreased cognitive performance and entorhinal cortex thickness as mean arterial pressure (MAP) increases, unlike Caucasian Americans (CAs). This highlights a potential hypertension-associated risk for cognitive brain health deficits in young AAs.
Area of Science:
- Neuroscience
- Cardiovascular Health
- Racial Health Disparities
Background:
- Race influences blood pressure (BP) and brain health in older adults.
- Differences in cardiovascular and brain function based on race are not well understood in younger populations.
Purpose of the Study:
- To investigate the interaction between race and BP on brain health in young African Americans (AAs) and Caucasian Americans (CAs).
Main Methods:
- Cross-sectional analysis of 971 younger adults (180 AAs, 791 CAs) from the Human Connectome Project.
- Assessment of cognitive composite scores, brain volume, and cortical thickness via MRI.
- ANCOVA used to examine interactions between race and mean arterial pressure (MAP) on cognitive and brain structure outcomes.
Main Results:
- Significant Race × MAP interaction effects found on cognitive scores and cortical thickness, after controlling for age, sex, education, and BMI.
- In AAs, but not CAs, increased MAP correlated with decreased global cognitive performance and entorhinal cortex (ERC) thickness.
Conclusions:
- MAP significantly moderates racial differences in cognitive performance and ERC thickness.
- Young AAs may face a higher risk of cognitive brain health deficits linked to hypertension.
- Early hypertension interventions in AAs could potentially reduce racial disparities in BP-related brain health.
Background:
Although there are moderating effects of race on blood pressure (BP) and brain health in older adults, it is currently unknown if these race-related differences in cardiovascular and associated brain function are also present in younger adults. The purpose of this study was to investigate the interaction between race and BP on brain health in younger African (AA) and Caucasian Americans (CA).
Methods:
We studied 971 younger adults (29.1 ± 3.5 years; 180 AAs and 791 CAs) who volunteered to participate in the Human Connectome Project. Cognitive composite scores, brain volume, and cortical thickness using MRI were cross-sectionally assessed. ANCOVA was used to examine interactions between race and mean arterial pressure (MAP) on cognitive test scores and brain structure.
Results:
After controlling for age, sex, education, and BMI, there were significant Race × MAP interaction effects on cognitive composite scores and cortical thickness. Among AAs but not CAs, as MAP increased, both global cognitive performance and entorhinal cortex (ERC) thickness decreased.
Conclusions:
MAP was an important moderator of racial differences in cognitive performance and ERC thickness. Our findings suggest that young AAs may carry a greater hypertension-associated risk for cognitive brain health deficit. Interventions that address early signs of hypertension in AAs are needed to determine if the racial disparities in BP-related brain health in late adulthood can be reduced.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.