title: Do systolic BP and pulse pressure relate to ventricular enlargement?
abstract: OBJECTIVE
  To evaluate the association between systolic, diastolic and pulse pressure, and increase in ventricular size (VS). Observations in laboratory animals suggest intraventricular pulse pressure (systolic-diastolic) may play a role in ventricular enlargement.
  
  
  METHODS
  Initial magnetic resonance (MR) scans and vascular risk factors evaluation were performed in 1812 Atherosclerosis Risk in Communities participants in 1994-1995. In 2004-2006, 1130 participants underwent repeat MR. VS was rated using a validated nine-point scale. Multiple logistic regression analysis assessed association between blood pressure measures and pulse pressure, and the change between the MR scans of VS controlling for age, sex and race.
  
  
  RESULTS
  At baseline 1112 participants (385 black women, 200 black men, 304 white women and 223 white men) had a mean age of 61.7 ± 4.3 years. In adjusted models pulse pressure at baseline was associated with an increase in VS [odds ratio (OR) 1.19, 95% confidence interval (CI) 1.01-1.40], as was systolic pressure (OR 1.28, 95% CI 1.03-1.58).
  
  
  CONCLUSIONS
  Systolic pressure and pulse pressure are associated with future development of increased VS. The findings are consistent with the animal literature that increased pulse pressure predisposes to risk of future increased VS. High pulse pressure might play a role in the pathogenesis of normal pressure hydrocephalus.
authors.affiliation: Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA. graffradford.neill@mayo.edu
authors.forename: N R
authors.initials: NR
authors.lastname: Graff-Radford
authors.forename: D S
authors.initials: DS
authors.lastname: Knopman
authors.forename: A D
authors.initials: AD
authors.lastname: Penman
authors.forename: L H
authors.initials: LH
authors.lastname: Coker
authors.forename: T H
authors.initials: TH
authors.lastname: Mosley
mesh_terms: D001794:Blood Pressure; D001921:Brain / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology; D002552:Cerebral Ventricles / Q000473:pathology*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011674:Pulse; D012307:Risk Factors; D013599:Systole