Related Experiment Video

Updated: Jun 16, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Long-Term Blood Pressure Variability in Cerebral Amyloid Angiopathy is Associated with Ischemic Brain Injury and

Lukas Sveikata1,2, Maria Clara Zanon Zotin1,3, Dorothee Schoemaker1

  • 1J. Philip Kistler Stroke Research Center, Department of Neurology Massachusetts General Hospital, Harvard Medical School Boston MA USA.

Journal of the American Heart Association
|June 15, 2026
PubMed

Insights

Long-term blood pressure variability (BPV) is linked to brain changes and cognitive decline, especially in those with probable cerebral amyloid angiopathy (CAA). Managing BPV may help prevent cognitive impairment in at-risk patients.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Gerontology

Background:

  • Long-term blood pressure variability (BPV) is a suspected risk factor for dementia and cerebral small vessel disease.
  • This study investigates the relationship between BPV, brain injury, and cognitive decline in probable cerebral amyloid angiopathy (CAA).

Purpose of the Study:

  • To assess the association between long-term BPV and white matter integrity in patients with probable CAA.
  • To determine if CAA modifies the impact of BPV on brain structure.
  • To examine the link between BPV and cognitive decline over time.

Main Methods:

  • A prospective cohort of 102 memory clinic patients (52 with probable CAA) were studied.
  • BPV was calculated over 5 years using outpatient measurements.
  • 3-tesla MRI was used to assess white matter integrity (peak width of skeletonized mean diffusivity) and CAA markers (lacunes, microinfarcts).

Main Results:

  • Systolic BPV showed a dose-dependent association with white matter integrity, independent of other risk factors.
  • The association between BPV and white matter changes was stronger in patients with probable CAA.
  • Higher BPV correlated with increased lacunes, microinfarcts, and cognitive decline in global cognition and processing speed.

Conclusions:

  • Long-term BPV is associated with impaired white matter integrity, ischemic brain injury, and cognitive decline.
  • Controlling BPV may be a therapeutic target for preventing cognitive decline in memory clinic patients with probable CAA.
Abstract

Keywords:
cerebral amyloid angiopathycognitive impairmenthypertensionmemory clinicstroke

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