title: Life-course blood pressure in relation to brain volumes.
abstract: The impact of blood pressure on brain volumes may be time-dependent or pattern-dependent.
  
  
  
  Of 1678 participants from the Atherosclerosis Risk in Communities Neurocognitive Study, we quantified the association between measures and patterns of blood pressure over three time points (∼24 or ∼15 years prior and concurrent with neuroimaging) with late life brain volumes.
  
  
  
  Higher diastolic blood pressure ∼24 years prior, higher systolic and pulse pressure ∼15 years prior, and consistently elevated or rising systolic blood pressure from ∼15 years prior to concurrent with neuroimaging, but not blood pressures measured concurrent with neuroimaging, were associated with smaller volumes. The pattern of hypertension ∼15 years prior and hypotension concurrent with neuroimaging was associated with smaller volumes in regions preferentially affected by Alzheimer's disease (e.g., hippocampus: -0.27 standard units, 95% CI: -0.51, -0.03).
  
  
  
  Hypertension 15 to 24 years prior is relevant to current brain volumes. Hypertension followed by hypotension appears particularly detrimental.
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA. Electronic address: melindacpower@gmail.com.
authors.forename: Melinda C
authors.initials: MC
authors.lastname: Power
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Andrea L C
authors.initials: AL
authors.lastname: Schneider
authors.affiliation: Department of Biostatistics, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Wruck
authors.affiliation: Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Griswold
authors.affiliation: Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Social Science & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Laura H
authors.initials: LH
authors.lastname: Coker
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Department of Radiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: David
authors.initials: D
authors.lastname: Knopman
authors.affiliation: Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Mosley
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Rebecca F
authors.initials: RF
authors.lastname: Gottesman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D014481:United States
keywords: Alzheimer's disease; Blood pressure; Brain volumes; Cohort study; Epidemiology; Human; Hypertension; Hypotension; Magnetic resonance imaging; Neurodegeneration