title: Association between ambulatory 24-hour blood pressure levels and brain volume reduction: a cross-sectional elderly population-based study.
abstract: Previous literature has shown mixed results regarding the association between blood pressure levels and brain volume reduction. The objectives of this study were to determine whether high blood pressure levels were associated with focal brain volume reduction and whether high blood pressure-related focal brain volume reduction was associated with a decline in executive function performance. On the basis of a cross-sectional design, 24-hour ambulatory blood pressure measurements, as well as brain morphology from 3-dimensional magnetic resonance images, were assessed among 183 participants (mean, 65 ± 0.6 years; 62.4% women). Average levels of systolic and diastolic blood pressures, as well as dip, pulse pressure, and mean arterial blood pressure, were used as outcomes. Cortical gray and white matter volumes were determined by automatic calculation using Statistical Parametric Mapping segmentation. Folstein's Mini-Mental State Examination, digit span, part B of Trail Making, and Stroop tests were used to assess executive function performance. Sex, use of antihypertensive drugs, duration of hypertension, leukoaraiosis, body mass index, education level, and total brain matter volume were used as potential confounders. A significant blood pressure-related decrease in gray matter volume of the left supplementary motor areas (Brodmann area 6) and of the left superior and middle frontal gyrus (Brodmann area 8) was shown. No significant decrease was found with white matter volume. Blood pressure-related decreases in gray matter volume were significantly associated with a decline in executive function performance. The association of high blood pressure with brain volume reduction may in part explain blood pressure-related cognitive decline leading to dementia.
authors.affiliation: Service de Physiologie Clinique et de l’Exercice, CHU Saint-Etienne, Faculté de Médecine Jacque Lisfranc, EA SNA EPIS 4607, UJM, Saint-Etienne, Pres de LYON, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Celle
authors.forename: Cédric
authors.initials: C
authors.lastname: Annweiler
authors.forename: Vincent
authors.initials: V
authors.lastname: Pichot
authors.forename: Robert
authors.initials: R
authors.lastname: Bartha
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Barthélémy
authors.forename: Frédéric
authors.initials: F
authors.lastname: Roche
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001931:Brain Mapping; D003071:Cognition / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance / Q000379:methods; D011597:Psychomotor Performance / Q000502:physiology; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents