title: Blood pressure, brain structure, and cognition: opposite associations in men and women.
abstract: BACKGROUND
  Research on associations between blood pressure, brain structure, and cognitive function has produced somewhat inconsistent results. In part, this may be due to differences in age ranges studied and because of sex differences in physiology and/or exposure to risk factors, which may lead to different time course or patterns in cardiovascular disease progression. The aim of this study was to investigate the impact of sex on associations between blood pressure, regional cerebral volumes, and cognitive function in older individuals.
  
  
  METHODS
  In this cohort study, brachial blood pressure was measured twice at rest in 266 community-based individuals free of dementia aged 68-73 years who had also undergone a brain scan and a neuropsychological assessment. Associations between mean blood pressure (MAP), regional brain volumes, and cognition were investigated with voxel-wise regression analyses.
  
  
  RESULTS
  Positive associations between MAP and regional volumes were detected in men, whereas negative associations were found in women. Similarly, there were sex differences in the brain-volume cognition relationship, with a positive relationship between regional brain volumes associated with MAP in men and a negative relationship in women.
  
  
  CONCLUSIONS
  In this cohort of older individuals, higher MAP was associated with larger regional volume and better cognition in men, whereas opposite findings were demonstrated in women. These effects may be due to different lifetime risk exposure or because of physiological differences between men and women. Future studies investigating the relationship between blood pressure and brain structure or cognitive function should evaluate the potential for differential sex effects.
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia; nicolas.cherbuin@anu.edu.au.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cherbuin
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia;
authors.forename: Moyra E
authors.initials: ME
authors.lastname: Mortby
authors.affiliation: Centre for Advanced Imaging, University of Queensland, Brisbane, Australia;
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Janke
authors.affiliation: Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia;
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
authors.affiliation: Medical School, Australian National University, Canberra, Australia.
authors.forename: Walter P
authors.initials: WP
authors.lastname: Abhayaratna
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia; Dementia Collaborative Research Centre-Early Diagnosis and Prevention, Australian National University, Canberra, Australia;
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000473:pathology*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D009929:Organ Size; D012737:Sex Factors
keywords: blood pressure; brain structure; cognitive function; epidemiology; hypertension; mean arterial pressure.; sex