Reduced cerebral blood flow in older men with higher levels of blood pressure.
OBJECTIVE
To examine relations of blood pressure (BP) with single photon emission computed tomography (SPECT)-derived estimates of cerebral blood flow in older men and women.


METHODS
Seventy-four stroke and dementia-free, community-dwelling older adults (ages 54-83 years; 68% men; 91% white) free of major medical, neurological, or psychiatric disease, engaged in clinical assessment of resting SBP and DBP, MRI rated for brain atrophy, and brain single photon emission computed tomography (SPECT) studies with computerized coding of cortical and select subcortical regions of interest.


RESULTS
Given significant interactions of BP and sex with respect to multiple SPECT outcomes, sex-stratified multiple regression models were computed. Models were adjusted for age, fasting glucose levels, antihypertensive medication, BMI, and MRI ratings of brain atrophy. In men (n = 50), higher levels of SBP and/or DBP were associated significantly with lower estimates of cerebral perfusion in the right and left frontal, temporal, parietal, and occipital cortex, thalamus, head of caudate, and cingulate cortex accounting for up to 28% of the variance in these measures (P < 0.05). In women (n = 24), higher DBP was related marginally to higher levels of perfusion in the right temporal cortex (P = 0.05).


CONCLUSIONS
Higher resting SBP or DBP was associated with lower levels of cerebral perfusion in otherwise healthy older men, but not women, in the present sample. Reduced cerebral blood flow may play a pathogenic role in increasing risk for stroke, dementia, and/or cognitive decline, particularly among older men with high BP.
Waldstein
Shari R
SR
Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA. waldstei@umbc.edu
Lefkowitz
David M
DM
Siegel
Eliot L
EL
Rosenberger
William F
WF
Spencer
Robert J
RJ
Tankard
Carol F
CF
Manukyan
Zorayr
Z
Gerber
Evie J
EJ
Katzel
Leslie
L
D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003971:Diastole; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics; D013599:Systole; D015899:Tomography, Emission-Computed, Single-Photon
J Cereb Blood Flow Metab. 2006 Feb;26(2):253-62
16079792
Hypertension. 2004 Nov;44(5):631-6
15466661
Neurobiol Aging. 2000 Mar-Apr;21(2):161-9
10867201
Stroke. 1993 Aug;24(8):1148-53
8342188
Lancet. 2002 Dec 14;360(9349):1903-13
12493255
Hypertens Res. 1995 Jun;18(2):111-7
7584916
JAMA. 2003 May 21;289(19):2560-72
12748199
Science. 1982 Aug 13;217(4560):659-61
7089587
J Gerontol A Biol Sci Med Sci. 1995 May;50(3):M147-54
7743400
Hypertension. 1992 Dec;20(6):816-20
1452297
Ann Neurol. 1984 Sep;16(3):314-20
6486737
Ann N Y Acad Sci. 2002 Nov;977:196-215
12480752
Ann N Y Acad Sci. 2000 Apr;903:411-23
10818532
Mech Ageing Dev. 2007 May-Jun;128(5-6):365-9
17451787
Stroke. 2007 Jun;38(6):1766-73
17510458
Stroke. 1987 Jan-Feb;18(1):13-20
3810745
Clin Exp Hypertens. 2005 Jan;27(1):45-57
15773229
Stroke. 1996 Dec;27(12):2262-70
8969791
Curr Hypertens Rep. 2005 Feb;7(1):68-71
15683589
Ann Neurol. 2005 Jun;57(6):789-94
15929050
Biomarkers. 2006 Nov-Dec;11(6):562-73
17056475
Hypertension. 2008 Dec;52(6):1113-9
18981325
J Hypertens. 1995 Jun;13(6):653-8
7594423
Hypertension. 2005 Mar;45(3):374-9
15699446