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Long-term Blood Pressure Exposure and Cerebral Microbleeds: a Retrospective Study from the META-KLS Cohort
Wenjuan Liu1, Jing Chen2, Jia Li3
1Department of Medical Imaging, Aerospace Center Hospital, Beijing, China.
Insights
Elevated cumulative systolic blood pressure (SBP) is a significant risk factor for cerebral microbleeds (CMBs) in community populations. This association is particularly noted for deep-type CMBs, highlighting SBP
Area of Science:
- Neurology
- Cardiovascular Science
- Medical Imaging
Background:
- The link between long-term blood pressure patterns and cerebral microbleeds (CMBs) in community settings is not well understood.
- Cerebral microbleeds are small lesions in the brain that can be associated with neurological conditions.
Purpose of the Study:
- To investigate the association between various long-term blood pressure factors and the presence of CMBs.
- To identify specific blood pressure metrics that may predict CMB occurrence in a community-based cohort.
Main Methods:
- Utilized data from the prospective longitudinal Multi-Modality Medical Imaging Study Based on the Kailuan Study (META-KLS).
- Analyzed brain MRI scans from 752 participants (aged 18-98) to detect CMBs.
- Calculated cumulative blood pressure exposure, variability, and trajectories, and performed regression analyses adjusting for confounders.
Main Results:
- Identified cumulative systolic blood pressure (SBP) as an independent risk factor for CMBs (OR=1.004).
- The association between cumulative SBP and CMBs remained significant after adjusting for demographic and cardiovascular risk factors (OR=1.002).
- Participants with deep-type CMBs exhibited significantly higher cumulative SBP compared to those with lobar-type CMBs.
Conclusions:
- Elevated cumulative SBP is a key risk factor for developing CMBs in the general population.
- The findings suggest that cumulative SBP specifically impacts deep brain tissue, leading to CMBs.
Introduction:
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.
Methods:
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.
Results:
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.
Conclusions:
In community population, elevated cumulative SBP is an important risk factor for CMBs, particularly affecting deep brain tissue.
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