Hypertension Trends and White Matter Brain Injury in the Offspring Framingham Heart Study Cohort
Year: 2023
Type: article
Abstract: BACKGROUND: Hypertension is the most potent stroke risk factor and is also related to cerebral small vessel disease. We studied the relation between mid-to-late-life hypertension trends and cerebral white matter injury in community-dwelling individuals from the FHS (Framingham Heart Study). METHODS: FHS Offspring cohort participants with available mid-life and late-life blood pressure measurements and brain magnetic resonance imaging were included. Multiple regression analyses were used to relate hypertension trends (normotension-normotension [reference], normotension-hypertension, and hypertension-hypertension) to white matter injury metrics on diffusion tensor imaging (free water, fractional anisotropy, and peak skeletonized mean diffusivity) and Fluid Attenuated Inversion Recovery (white matter hyperintensity volume) by different blood pressure cutoffs (130/80, 140/90, and 150/90 mm Hg). RESULTS: We included 1018 participants (mean age 47.3±7.4 years at mid-life and 73.2±7.3 at late-life). At the 140/90 mm Hg cutoff, the hypertension-hypertension trend was associated with higher free water (β, 0.16 [95% CI, 0.03–0.30]; P =0.021) and peak skeletonized mean diffusivity (β, 0.15 [95% CI, 0.01–0.29]; P =0.033). At a 130/80 mm Hg cutoff, the hypertension-hypertension trend had significantly higher free water (β, 0.16 [95% CI, 0.01–0.30]; P =0.035); and the normotension-hypertension (β, 0.24 [95% CI, 0.03–0.44]; P =0.027) and hypertension-hypertension (β, 0.22 [95% CI, 0.04–0.41]; P =0.022) trends had significantly increased white matter hyperintensity volume. Exploratory stratified analysis showed effect modifications by APOE ɛ4 allele and age. CONCLUSIONS: Mid-to-late-life hypertension exposure is significantly associated with microstructural and to a lesser extent, visible white matter injury; the effects are observed at both conventional and lower blood pressure cutoffs and are associated with longer duration of hypertension.
Source: Hypertension
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1035741774, UC Davis Alzheimer's Disease Core Center, G1735617348, Therapeutic target discovery in ADSP data via comprehensive whole-genome analysis incorporating ethnic diversity and systems approaches, G250621538, Ventricular Matrix Remodeling: Correlates and Prognosis, Risk Factors, Genetics and Cognition in Cerebral Microbleeds: Framingham Study, G278200998, Aldosterone in Vascular Remodeling and Dysfunction, Aging and Inflammation: Longitudinal Markers and Genetics in the Framingham Study, G4976486911, Temporal Trends, Novel Imaging and Molecular Characterization of Preclinical and Clinical Alzheimer's Disease in the Framingham Cohorts, G5164707915, Longitudinal Risk Factor Changes and Early Recognition of Cerebral Small Vessel Disease, Preclinical AD: Correlates of Amyloid, Tau PET and fcMRI in Framingham Gen 3 Young Adults, Cerebral Microbleeds in Young Adults: risk factors, biomarkers and genetics, MRI, Cognitive, Genetic and Biomarker Precursors of AD & Dementia in Young Adults, Framingham: Inflammation, Genes & Cardiovascular Disease, The Framingham Heart Study, Enlarged Perivascular Spaces as Markers of Vascular and Alzheimer pathology: predictors, pathophysiology and clinical consequences, G7264467602, G8326557007, G8566141481, Cognitively Healthy Nonagenarians in the Cross Cohort Collaboration (CCC), Epidemiology of Dementia in the Framingham Study, G8962124162, G9000108235, G9000124674, UC Davis Alzheimer's Disease Research Center, Precursors of Stroke Incidence and Prognosis, Multidisciplinary Training Program in Cardiovascular Epidemiology, South Texas Alzheimer's Disease Center
OpenAlex ID: W4387764702