title: The impact of hypertension on cerebral perfusion and cortical thickness in older adults.
abstract: Hypertension may increase risk for dementia possibly because of its association with decreased cortical thickness. Disturbed cerebral autoregulation is one plausible mechanism by which hypertension impacts the cerebral structure, but the associations among hypertension, brain perfusion, and cortical thickness are poorly understood. The current sample consisted of 58 older adults with varying levels of vascular disease. Diagnostic history of hypertension and antihypertensive medication status was ascertained through self-report, and when available, confirmed by medical record review. All participants underwent arterial spin labeling and T1-weighted magnetic resonance imaging to quantify total and regional cortical perfusion and thickness. Analysis of covariance adjusting for medical variables showed that participants with hypertension exhibited reduced temporal and occipital brain perfusion and total and regional cortical thickness relative to those without hypertension. The effects of hypertension on total brain perfusion remained unchanged even after adjustment for age, although no such pattern emerged for cortical thickness. Decreased total brain perfusion predicted reduced thickness of the total brain and of the frontal, temporal, and parietal lobe cortices. Antihypertensive treatment was not associated with total cerebral perfusion or cortical thickness. This study provides initial evidence for the adverse effects of a diagnostic history of hypertension on brain hypoperfusion and reduced cortical thickness. Longitudinal studies are needed to investigate the role of hypertension and its interaction with other contributing factors (e.g., age) in the manifestation of cerebral hypoperfusion and reduced cortical thickness.
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA. Electronic address: Malosco@kent.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Alosco
authors.affiliation: Department of Psychology, Kent State University, Kent, OH, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: Department of Psychology, Idaho State University, Pocatello, ID, USA.
authors.forename: Xiaomeng
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Uraina S
authors.initials: US
authors.lastname: Clark
authors.affiliation: Alpert Medical School of Brown University, the Department of Psychiatry and Human Behavior, Providence, RI, USA.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Labbe
authors.affiliation: Brain Behavior and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: Hannah H
authors.initials: HH
authors.lastname: Riskin-Jones
authors.affiliation: Alpert Medical School of Brown University, Providence, RI, USA.
authors.forename: Gretel
authors.initials: G
authors.lastname: Terrero
authors.affiliation: Department of Psychology, University of Georgia, Athens, GA, USA.
authors.forename: Nicolette F
authors.initials: NF
authors.lastname: Schwarz
authors.affiliation: Brown University, Departments of Neuroscience and Diagnostic Imaging., Providence, RI, USA.
authors.forename: Edward G
authors.initials: EG
authors.lastname: Walsh
authors.affiliation: Alpert Medical School of Brown University, Department of Medicine, Providence, RI, USA.
authors.forename: Athena
authors.initials: A
authors.lastname: Poppas
authors.affiliation: Cognitive Aging and Memory Program, Clinical Translational Research Program, Institute on Aging, University of Florida, Gainesville, FL, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Cohen
authors.affiliation: Alpert Medical School of Brown University, the Department of Psychiatry and Human Behavior, Providence, RI, USA; Department of Psychology, University of Georgia, Athens, GA, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Sweet
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002540:Cerebral Cortex / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D015140:Dementia, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology*
keywords: Arterial spin labeling; Blood pressure; brain structure; cerebral blood flow