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BLOOD PRESSURE INDICES ARE ASSOCIATED WITH INCREASED REDUCED HIPPOCAMPAL VOLUME AND WHITE MATTER HYPERINTENSITIES IN HISPANIC ADULTS: THE MARACAIBO AGING STUDY

Alzheimers & Dementia(2016)

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摘要
Hypertension has been associated with increased risk of Alzheimer disease (AD). To understand how hypertension affects AD and related traits, we examined the contributions from components of hypertension on relative hippocampal volume (RHV) and white matter hyperintensities (WMH). We hypothesize that some components of hypertension will be better predictors of reduced RHV or increased WMH, which in turn may lead to increased risk of AD. Here we examined how 4 blood pressure (BP) indices – systolic BP (SBP), diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP) – are associated with RHV and WMH in middle age and elderly participants in the Maracaibo Aging Study. We studied 73 participants (≥40 years of age). A comprehensive evaluation of neuropsychological and medical assessment was performed, including brain MRI scans. We assed hypertension and RHV and WMH using univariate and multivariate linear regression, adjusting for confounders. To determine which components contribute to changes in RHV and WMH, we examined SBP, DBP, PP and MAP individually, and then performed joint analyses (e.g., SPB+PP vs DBP+PP, etc) to account for their inter-related nature. RHV. In multivariate modeling, SBP (β=-0.496, p<0.0001), PP (β=-0.503, p=0.002) and MAP (β=-0.378, p=0.004) were significantly associated with RHV. When SBP was analyzed jointly with DBP, SBP was associated with reduced RHV (β=-0.534, p=0.006), but DBP was not significantly associated. When DBP was jointly analyzed with PP, PP was associated with lower RHV (β=-0.455, p=0.006). Joint analyses of PP with SBP or MAP were not significantly associated with RHV. WMH. In multivariate modeling, SBP (β=0.527, p=0.001), DBP (β=0.343, p=0.008), PP (β=0.46, p=0.001) and MAP (β=0.464, p=0.001) were associated with increased levels of WMH. When SBP was analyzed jointly with PP, SBP was associated with reduced WMH (β=0.727, p=0.036), but PP was not. When DBP was jointly analyzed with PP, both DBP (β=0.271, p=0.036) and PP (β=0.36, p=0.04) were associated with increased levels of WMH. In this Hispanic cohort, combining PP with SBP or DBP can provide greater insight into the relationship of hypertension and brain imaging measures in relation to AD risk.
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关键词
increased reduced hippocampal volume,blood pressure indices,hispanic adults,blood pressure
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