title: Association between blood pressure levels over time and brain atrophy in the elderly.
abstract: The relation between blood pressure level and degree of global brain atrophy is equivocal. We evaluated past and present blood pressure levels and change in blood pressure over 20 years in relation to the degree of cortical atrophy on magnetic resonance imaging (MRI). In 1995-1996, we measured blood pressure and performed MRI in 1077 nondemented elderly (age 60-90 years). For 513 of these, we had information on a blood pressure level 20 years before. The degree of cortical atrophy was semi-quantitatively scored (range 0-15). In late life, a high (>/=90 mmHg) and low (<65 mmHg) diastolic blood pressure were associated with more cortical atrophy than a diastolic blood pressure level between 65-74 mmHg (adjusted difference 0.60 units (95% confidence interval (CI), 0.18-1.02) and 0.77 units (0.28-1.25), respectively). Persons whose diastolic blood pressure had declined more than 10 mmHg over 20 years had more cortical atrophy than those with stable blood pressure levels (adjusted difference 0.53 units, 0.05-1.02). Both high and declining diastolic blood pressure levels are associated with more global brain atrophy on MRI.
authors.affiliation: Department of Epidemiology and Biostatistics, Erasmus Medical Center, 3000 sDR, Rotterdam, The Netherlands.
authors.forename: Tom den
authors.initials: Td
authors.lastname: Heijer
authors.forename: Ingmar
authors.initials: I
authors.lastname: Skoog
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.forename: Frank-Erik
authors.initials: FE
authors.lastname: de Leeuw
authors.forename: Jan Cees
authors.initials: JC
authors.lastname: de Groot
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Monique M B
authors.initials: MM
authors.lastname: Breteler
mesh_terms: D000368:Aged; D001284:Atrophy; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D003704:Dementia / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors