title: Joint effect of mid- and late-life blood pressure on the brain: the AGES-Reykjavik study.
abstract: We hypothesized that in participants with a history of hypertension, lower late-life blood pressure (BP) will be associated with more brain pathology.
  
  
  
  Participants are 4,057 older men and women without dementia with midlife (mean age 50 ± 6 years) and late-life (mean age 76 ± 5 years) vascular screening, cognitive function, and brain structures on MRI ascertained as part of the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.
  
  
  
  The association of late-life BP to brain measures depended on midlife hypertension history. Higher late-life systolic and diastolic BP (DBP) was associated with an increased risk of white matter lesions and cerebral microbleeds, and this was most pronounced in participants without a history of midlife hypertension. In contrast, in participants with a history of midlife hypertension, lower late-life DBP was associated with smaller total brain and gray matter volumes. This finding was reflected back in cognitive performance; in participants with midlife hypertension, lower DBP was associated with lower memory scores.
  
  
  
  In this large population-based cohort, late-life BP differentially affects brain pathology and cognitive performance, depending on the history of midlife hypertension. Our study suggests history of hypertension is critical to understand how late-life BP affects brain structure and function.
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Majon
authors.initials: M
authors.lastname: Muller
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Olafur
authors.initials: O
authors.lastname: Kjartansson
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Lopez
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Palmi V
authors.initials: PV
authors.lastname: Jonnson
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Mark
authors.initials: M
authors.lastname: van Buchem
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik.
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.affiliation: From the Laboratory of Epidemiology and Population Sciences (M.M., T.B.H., L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD; the Departments of Gerontology and Geriatrics (M.M.) and Radiology (M.v.B.), Leiden University Medical Center; Icelandic Heart Association (S.S., O.K., T.A., V.G.), Kopovagur; the Departments of Neurology & Radiology (O.K.) and Geriatrics (P.V.J.), Landspitali National University Hospital, Reykjavik, Iceland; the Department of Neurology (O.L.L.), University of Pittsburgh, PA; and the Faculty of Medicine (P.V.J.), University of Iceland, Reykjavik. LaunerL@nia.nih.gov.
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology / Q000502:physiology; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000502:physiology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D007055:Iceland / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies