Differences between treated and untreated hypertensive subjects in the extent of periventricular hyperintensities observed on brain MRI.
OBJECTIVE
Several reports have stated that the periventricular abnormalities found on T2-weighted MRI or CT are associated with age and hypertension. However, there have been no reports on the effect of hypertension treatment on white matter abnormalities. We studied the association between cardiovascular risk factors and periventricular hyperintensities (PVHs) on T2-weighted MRI and the differences between treated and untreated hypertensive subjects in the extent of PVHs.


METHODS
The extent of PVH observed on 238 MRI scans was assessed retrospectively in 238 patients older than 40 years with the use of a five-point (0 to 4) classification scale. Hypertensive subjects were divided into two groups: patients receiving no or irregular treatment and patients receiving regular treatment for hypertension.


RESULTS
Age, hypertension, treatment of hypertension, and multiple cerebral vascular lesions on MRI correlated significantly and independently with the extent of PVH. Sex and diabetes mellitus did not correlate with PVH. The Mann-Whitney U test showed significantly more extensive PVH in subjects with no or irregular treatment of hypertension compared with normotensives (2.5 +/- 0.7 versus 1.9 +/- 0.6, P < .0001) and compared with subjects receiving regular treatment of hypertension (2.5 +/- 0.7 versus 2.1 +/- 0.5, P = .0019). The latter patients had more extensive PVH than normotensives, but the difference was not significant. Mean systolic and diastolic blood pressure differed significantly among the three groups.


CONCLUSIONS
Hypertension and age were major predictors of the extent of PVH. Regular treatment for hypertension appeared to prevent the progression of PVH.
Fukuda
H
H
Department of Neurology, Masuda Red Cross Hospital, Shimane, Japan.
Kitani
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002544:Cerebral Infarction / Q000175:diagnosis / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000473:pathology*; D007089:Image Enhancement; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000473:pathology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors
D000959:Antihypertensive Agents