title: Interactive relations of blood pressure and age to subclinical cerebrovascular disease.
abstract: OBJECTIVE
  To examine interactive relations of blood pressure (BP) and age to MRI indices of subclinical cerebrovascular disease in middle-aged to older adults.
  
  
  METHODS
  One hundred and thirteen stroke-free and dementia-free, community-dwelling adults (ages 54-81 years; 65% men; 91% white) engaged in (1) clinical assessment of resting SBP and DBP; (2) MRI rated for periventricular white matter hyperintensities (WMH) and deep WMH silent brain infarction (SBI) and brain atrophy (i.e. ventricular enlargement and sulcal widening ). Principal components analysis of the MRI ratings yielded a two-component solution--(1) periventricular and deep WMH SBI; and (2) ventricular enlargement, sulcal widening.
  
  
  RESULTS
  Relations of SBP, DBP and pulse pressure (PP) (and their interactions with age) to each MRI component were examined in multiple regression analyses adjusted for age, sex, fasting plasma glucose and cholesterol, and antihypertensives. For component 1, results indicated significant interactions of SBP and PP with age (P < 0.05); higher levels of SBP and PP were associated with greater white matter disease and brain infarction at younger ages (≤ 68 years). Significant interactions of SBP and DBP with age were also noted for component 2 (P < 0.05); higher levels of BP were associated with greater brain atrophy at younger ages (≤ 63 years).
  
  
  CONCLUSIONS
  : Higher BP and PP are associated with greater subclinical cerebrovascular disease most prominently in the 'young old'. Appropriate management of hypertension and arterial stiffening may be critical to the preservation of brain structure with ageing.
authors.affiliation: Department of Psychology, University of Maryland, Baltimore County, Baltimore, Maryland 21250, USA. waldstei@umbc.edu
authors.forename: Shari R
authors.initials: SR
authors.lastname: Waldstein
authors.forename: Carrington R
authors.initials: CR
authors.lastname: Wendell
authors.forename: David M
authors.initials: DM
authors.lastname: Lefkowitz
authors.forename: Eliot L
authors.initials: EL
authors.lastname: Siegel
authors.forename: William F
authors.initials: WF
authors.lastname: Rosenberger
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spencer
authors.forename: Zorayr
authors.initials: Z
authors.lastname: Manukyan
authors.forename: Leslie I
authors.initials: LI
authors.lastname: Katzel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors