Long-term Blood Pressure Exposure and Cerebral Microbleeds: a Retrospective Study from the META-KLS Cohort

The relationship between long-term blood pressure factors and cerebral microbleeds (CMBs) in community populations remains unclear. This study aimed to elucidate the associations between various long-term blood pressure factors and the occurrence of CMBs within the Kailuan cohort.

Data were obtained from adults participating in the Multi-Modality Medical Imaging Study Based on the Kailuan Study (META-KLS), a prospective longitudinal community study initiated in 2006, involving participants aged 18-98 years. A total of 752 participants underwent brain magnetic resonance imaging (MRI) between 2021 and 2022. We calculated long-term blood pressure factors, including cumulative exposure, long-term blood pressure variability, and blood pressure trajectories, using established formulas and trajectory models. Linear regression analyses were conducted to examine the associations between these blood pressure factors and the presence of CMBs, adjusting for demographic factors, cardiovascular risk factors, and cerebral blood flow on MRI. Brain MRI outcomes included the presence and classification of CMBs.

A total of 752 participants were included, with a mean age of 56.4 ± 10.8 years. Of these, 448 (59.6%) were men and 304 (40.4%) were women. A diagnosis of CMBs was established in 172 individuals, accounting for 22.9% of the cohort. Cumulative systolic blood pressure (SBP) was identified as an independent risk factor for the occurrence of CMBs (OR = 1.004, 95%CI: 1.002-1.005). This association remained significant after adjusting for sociodemographic and cardiovascular risk factors (OR = 1.002, 95% CI: 1.000-1.004). Participants with deep-type CMBs had significantly higher cumulative SBP compared to those with lobar-type CMBs (P = 0.005). No significant correlations were found between the occurrence of CMBs and cumulative diastolic blood pressure (DBP), cumulative pulse pressure difference, blood pressure trajectories, or long-term blood pressure variability.

In community population, elevated cumulative SBP is an important risk factor for CMBs, particularly affecting deep brain tissue.