title: Lower Blood Pressure Is Associated With Smaller Subcortical Brain Volumes in Older Persons.
abstract: BACKGROUND
  Both high and low blood pressure (BP) have been positively as well as negatively associated with brain volumes in a variety of populations. The objective of this study was to investigate whether BP is associated with cortical and subcortical brain volumes in older old persons with mild cognitive deficits.
  
  
  METHODS
  Within the Discontinuation of Antihypertensive Treatment in the Elderly trial, the cross-sectional relation of BP parameters with both cortical and subcortical brain volumes was investigated in 220 older old persons with mild cognitive deficits (43% men, mean age = 80.7 (SD = 4.1), median Mini-Mental State Examination score = 26 (interquartile range: 25-27)), using linear regression analysis. All analyses were adjusted for age, gender, volume of white matter hyperintensities, and duration of antihypertensive treatment. Brain volumes were determined on 3DT1-weighted brain magnetic resonance imaging scans.
  
  
  RESULTS
  Lower systolic BP, diastolic BP, and mean arterial pressure (MAP) were significantly associated with lower volumes of thalamus and putamen (all P ≤ 0.01). In addition, lower MAP was also associated with reduced hippocampal volume (P = 0.035). There were no associations between any of the BP parameters with cortical gray matter or white matter volume.
  
  
  CONCLUSIONS
  In an older population using antihypertensive medication with mild cognitive deficits, a lower BP, rather than a high BP is associated with reduced volumes of thalamus, putamen, and hippocampus.
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; j.c.foster-dingley@lumc.nl.
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Foster-Dingley
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Jeroen
authors.initials: J
authors.lastname: van der Grond
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Justine E F
authors.initials: JE
authors.lastname: Moonen
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Anne A
authors.initials: AA
authors.lastname: van den Berg-Huijsmans
authors.affiliation: Department of Public health and Primary care, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Wouter
authors.initials: W
authors.lastname: de Ruijter
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Mark A
authors.initials: MA
authors.lastname: van Buchem
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Anton J M
authors.initials: AJ
authors.lastname: de Craen
authors.affiliation: Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands;
authors.forename: Roos C
authors.initials: RC
authors.lastname: van der Mast
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects; D062186:Arterial Pressure; D001794:Blood Pressure / Q000187:drug effects; D001921:Brain / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D056784:Leukoencephalopathies / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D009426:Netherlands; D065840:Protective Factors; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; brain; cross-sectional study; elderly; hypertension; magnetic resonance imaging.