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Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based
J J Claus1, M M Breteler, D Hasan
1Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Insights
High blood pressure and fibrinogen levels are linked to reduced cerebral blood flow in older adults. Low diastolic blood pressure also significantly impacts temporo-parietal blood flow, suggesting implications for hypertension management in the elderly.
Area of Science:
- Neurology
- Gerontology
- Cardiovascular Science
Background:
- Cerebral vascular disease risk factors require further investigation in aging populations.
- Understanding determinants of regional cerebral blood flow (rCBF) is crucial for cognitive health.
- Atherosclerosis and white matter lesions are common in the elderly, potentially affecting brain perfusion.
Purpose of the Study:
- To examine associations between vascular risk factors, atherosclerosis indicators, and white matter lesions with rCBF in older adults.
- To identify potential threshold effects in these relationships.
- To inform strategies for blood pressure management in the elderly.
Main Methods:
- Cross-sectional study of 60 individuals aged 65-85 years from a population-based cohort.
- Regional cerebral blood flow (rCBF) measured using single-photon emission tomography (99mTc-HMPAO).
- Statistical analysis employed multiple linear regression, adjusting for age, sex, and ventricle-to-brain ratio.
Main Results:
- Systolic and diastolic blood pressure showed a significant positive association with temporo-parietal rCBF.
- Low diastolic blood pressure (
- High plasma fibrinogen levels (>3.2 g/l) were inversely related to parietal rCBF, also showing a threshold effect.
- Atherosclerosis indicators were related to reduced cortical rCBF, though not significantly.
- Cerebral white matter lesion severity did not show a consistent relationship with rCBF.
Conclusions:
- Blood pressure and fibrinogen levels are significant factors associated with reduced cerebral blood flow in older adults.
- Threshold effects observed for low diastolic blood pressure and high fibrinogen highlight critical levels impacting brain perfusion.
- Findings underscore the importance of blood pressure control in the elderly to maintain adequate cerebral blood flow and potentially mitigate vascular risks.
Abstract:
We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d, l-hexamethylpropylene amine oxime (99mTc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure (3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population.