title: Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women.
abstract: Hypertension is associated with development of white matter hyperintensities (WMH) in the brain, which are risk factors for mild cognitive impairment. Hormonal shifts at menopause alter vascular function putting women at risk for both hypertension and WMH. Elevations in aortic hemodynamics precede the appearance of clinically defined hypertension but the relationship of aortic hemodynamics to development of WMH in women is not known. Therefore, this study aimed to characterize aortic hemodynamics in relationship to WMH in postmenopausal women. Aortic systolic and diastolic blood pressure (BP), aortic augmentation index (Alx) and aortic round trip travel time (Aortic TR) by tonometry were examined in 53 postmenopausal women (age 60 ± 2 years). WMH was calculated from fluid-attenuated inversion recovery MRI using a semi-automated segmentation algorithm. WMH as a fraction of total white matter volume positively associated with aortic systolic BP (regression coefficient = 0.018; p = 0.04) after adjusting for age. In addition, WMH fraction was positively associated with AIx (0.025; p = 0.04), and inversely associated with Aortic TR(-0.015; p = 0.04) after adjusting for age. Our results suggest that assessing aortic hemodynamics may identify individuals at risk for accelerated development of WMH and guide early treatment to reduce WMH burden and cognitive impairment in the future.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.|Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jill N
authors.initials: JN
authors.lastname: Barnes
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Ronée E
authors.initials: RE
authors.lastname: Harvey
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
authors.forename: Samantha M
authors.initials: SM
authors.lastname: Zuk
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Emily S
authors.initials: ES
authors.lastname: Lundt
authors.affiliation: Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Lesnick
authors.affiliation: Department of Informational Technology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Gunter
authors.affiliation: Department of Informational Technology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Senjem
authors.affiliation: Department of Internal Medicine, Women's Health Clinic, Mayo Clinic, Rochester, MN, USA.
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Shuster
authors.affiliation: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.|Department of Surgery, Mayo Clinic, Rochester, MN, USA.
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Miller
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Jack
authors.affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Joyner
authors.affiliation: Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. Kantarci.Kejal@mayo.edu.
authors.forename: Kejal
authors.initials: K
authors.lastname: Kantarci
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017698:Postmenopause; D066127:White Matter / Q000000981:diagnostic imaging*
chemical_list: D002097:C-Reactive Protein
keywords: Blood pressure; Cerebrovascular disease; Cognitive aging; MRI; Stroke prevention