title: Blood pressure components and changes in relation to white matter lesions: a 32-year prospective population study.
abstract: This study aimed to examine the long-term effect of high blood pressure (systolic blood pressure, diastolic blood pressure, pulse pressure, and mean arterial pressure) on white matter lesions and to study changes in different blood pressure components in relation to white matter lesions. A representative population of women was examined in 1968 and re-examined in 1974, 1980, 1992, and 2000. The presence and severity of white matter lesions on computed tomography were rated by a visual rating scale in 1992 and 2000 in 539 women. Systolic and diastolic blood pressures were measured at all of the examinations. We found that presence and severity of white matter lesions in 1992/2000 were associated with higher diastolic blood pressure and mean arterial pressure at each examination but not with systolic blood pressure and pulse pressure. Odds ratios (95% CIs) for the presence of white matter lesions per 10-mm Hg increase in diastolic pressure were 1.4 (1.0 to 1.9) in 1968, 1.3 (1.0 to 1.8) in 1974, 1.4 (1.1 to 1.9) in 1980, and 1.3 (1.0 to 1.6) in 1992 after adjustment for confounders. The presence of white matter lesions was also associated with a 24-year increase in diastolic pressure (>10 mm Hg), systolic pressure (>40 mm Hg), pulse pressure (>24 mm Hg), and mean arterial pressure (>6 mm Hg; odds ratios [95% CIs]: 2.6 [1.3 to 5.1] for diastolic pressure; 2.0 [1.2 to 3.4] for systolic pressure; 1.8 [1.1 to 2.7] for pulse pressure; and 2.2 [1.4 to 3.4] for mean arterial pressure). Our findings suggest that lowering high diastolic blood pressure and preventing large increases in systolic and diastolic blood pressures may have a protective effect on white matter lesions.
authors.affiliation: Institute of Neuroscience and Physiology, University of Gothenburg, Sweden. xinxin.guo@neuro.gu.se
authors.forename: Xinxin
authors.initials: X
authors.lastname: Guo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.forename: Michela
authors.initials: M
authors.lastname: Simoni
authors.forename: Calle
authors.initials: C
authors.lastname: Bengtsson
authors.forename: Cecilia
authors.initials: C
authors.lastname: Björkelund
authors.forename: Lauren
authors.initials: L
authors.lastname: Lissner
authors.forename: Deborah
authors.initials: D
authors.lastname: Gustafson
authors.forename: Ingmar
authors.initials: I
authors.lastname: Skoog
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D013548:Sweden; D013997:Time Factors; D014057:Tomography, X-Ray Computed