Progression of white matter hyperintensities is related to blood pressure increases and global cognitive decline - A...

Area of Science:

• Neurology
• Neuroimaging
• Vascular Biology

Background:

• White matter hyperintensities (WMH) are markers of cerebral small vessel disease (cSVD), a key factor in cognitive decline and dementia.
• Vascular risk factors like diastolic blood pressure (DBP) are linked to WMH progression, but effects of abdominal obesity and sex/gender differences require further study.

Purpose of the Study:

• To investigate the association of baseline DBP and waist-to-hip ratio (WHR) with WMH progression.
• To examine the relationship between WMH progression and cognitive functions (executive and global).
• To explore sex/gender-specific effects on WMH progression.

Main Methods:

• Longitudinal population-based neuroimaging cohort study with 596 participants (mean age 63.2 years).
• Two MRI scans over approximately 6 years to assess WMH progression.
• Linear mixed models used to analyze associations of DBP and WHR with WMH progression, including gender interaction and stratified analyses.

Main Results:

• No significant association found between baseline DBP and WMH progression.
• WMH progression significantly predicted global cognitive decline, but not executive function decline.
• Exploratory analyses indicated associations between increases in DBP, and baseline/increases in systolic blood pressure with WMH progression, particularly in frontal regions.
• No association found for WHR or any gender-specific effects on WMH progression.

Conclusions:

• While baseline DBP was not a significant predictor, WMH progression is linked to global cognitive decline.
• Blood pressure control may be crucial for limiting WMH progression and preserving cognitive function in middle-aged and older adults.
• Further research may clarify the role of systolic blood pressure and regional WMH changes.