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Optimal systolic and diastolic blood pressure threshold that associated with lower risk of white matter

Sibo Liu1, Mengxing Wang2, De'an Gu3

  • 1Intensive Care Unit, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China.

Frontiers in Aging Neuroscience
|November 6, 2023
PubMed

Insights

Maintaining systolic blood pressure (SBP) below 130 mmHg and diastolic blood pressure (DBP) below 80 mmHg may lower the risk of white matter hyperintensity (WMH) progression. Higher SBP levels were significantly linked to increased WMH severity.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Optimal blood pressure control thresholds for white matter hyperintensity (WMH) remain unclear.
  • WMH is associated with neurological deficits and cognitive decline.
  • Understanding blood pressure's role in WMH progression is crucial for preventative strategies.

Purpose of the Study:

  • To investigate the association between blood pressure control and white matter hyperintensity (WMH) progression.
  • To determine optimal systolic blood pressure (SBP) and diastolic blood pressure (DBP) thresholds for patients with WMH.
  • To evaluate the impact of longitudinal blood pressure variability on WMH progression.

Main Methods:

  • A longitudinal retrospective study involving 457 patients with brain MRI scans and detailed blood pressure records.
  • Patients were categorized into WMH absent, mild WMH, and moderate to severe WMH groups.
  • Change in total WMH volume from baseline to follow-up was the primary outcome measure.

Main Results:

  • Both baseline and longitudinal mean SBP and DBP were significantly associated with WMH severity (p < 0.05).
  • An average SBP of 130-140 mmHg was linked to a higher risk of WMH progression (aOR = 1.80).
  • DBP ≥ 90 mmHg showed a trend towards higher WMH progression risk, but this was not statistically significant after covariate adjustment.

Conclusions:

  • Both SBP and DBP show a significant relationship with WMH severity.
  • A target mean SBP < 130 mmHg and mean DBP < 80 mmHg is associated with a lower risk of WMH progression.
  • Current findings suggest stricter blood pressure control may be beneficial for patients with WMH.
Abstract

Keywords:
blood pressureblood pressure variabilitydiastolic blood pressuresystolic blood pressurewhite matter hyperintensity

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