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Associations of Blood Pressure Level and Variability With Cortical Thickness: A Cross-Sectional Analysis From the
Romeo De Leon1,2, Shana Garza1, Silvia Mejia-Arango1,3,4
1Institute of Neuroscience, Neuro and Behavioral Integrated Service Unit, School of Medicine, University of Texas Rio Grande Valley, Harlingen, Texas, USA.
Insights
High blood pressure (BP) levels and variability, especially when measured outside the clinic, are linked to reduced cortical thickness in brain areas affected by Alzheimer's disease (AD). Ambulatory BP monitoring may help detect early brain changes.
Area of Science:
- Neurology
- Cardiology
- Radiology
Background:
- High blood pressure (BP) and its variability are linked to Alzheimer's Disease (AD).
- The association between BP and cortical thickness in AD-related brain regions remains unclear.
- The role of 24-hour BP monitoring in this context has not been extensively studied.
Purpose of the Study:
- To investigate the relationship between office and 24-hour ambulatory BP measures and cortical thickness in AD-associated brain regions.
- To examine the impact of BP levels and variability on brain structure in individuals without dementia.
Main Methods:
- Cross-sectional analysis of 304 participants without dementia.
- Utilized office and 24-hour ambulatory BP data.
- Assessed cortical thickness in 10 AD-relevant brain regions using MRI.
- Employed adjusted linear regression models to test associations.
Main Results:
- Higher office systolic BP correlated with thinner temporal and posterior cingulate cortex.
- Elevated 24-hour and nighttime BP levels were associated with thinner cortical regions.
- Increased 24-hour BP variability linked to thinner frontal, temporal, and posterior cingulate cortex.
Conclusions:
- Ambulatory BP levels and variability are associated with cortical thinning in AD-relevant brain areas.
- Out-of-office BP monitoring may offer better insights into brain structural changes related to AD.
- Early detection of BP-related brain changes could inform AD prevention strategies.
Background:
Although high blood pressure (BP) level and variability are associated with Alzheimer's disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-h BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.
Methods:
We performed a cross-sectional analysis of 304 participants without dementia from a population-based study with office and 24-h BP and magnetic resonance imaging data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and temporal lobes, and the posterior cingulate cortex that are associated with risk and progression of AD. The association between BP and cortical thickness was tested using adjusted linear regression models.
Results:
The mean age was 58.1 years and 231 (76%) were women. Higher office systolic BP was associated with thinner temporal (β = -0.059; 95% confidence interval [CI], -0.112, -0.005) and posterior cingulate cortex (β = -0.095; 95% CI, -0.145, -0.045). 24-h and nighttime BP levels were associated with thinner seven regions, with β-estimates ranging from -0.103 (95% CI, -0.182, -0.012) to -0.045 (95% CI, -0.080, -0.010). A higher 24-h BP variability was associated with thinner middle frontal (β = -0.156; 95% CI, -0.282, -0.030) and middle temporal (β = -0.146; 95% CI, -0.268, -0.024) gyri, and posterior cingulate cortex (β = -0.134; 95% CI, -0.026, -0.009).
Conclusions:
Increased ambulatory BP level and variability are associated with cortical thinning in regions associated with AD. Better BP evaluation with out-of-office approaches might reduce brain structural changes associated with AD.
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