Progression of cerebral white matter hyperintensities on MRI is related to diastolic blood pressure

Background and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension.Methods We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images.Results Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (P=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (P=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F1,248=6.750, P=0.010), but not in those without hypertension (P=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension.Conclusions Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.

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Arterial stiffness and progression of cerebral white matter hyperintensities in patients with type 2 diabetes and matched controls: a 5-year cohort study

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00691-y ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Kristian L. Funck ◽

Esben Laugesen ◽

Pernille Høyem ◽

Brian Stausbøl-Grøn ◽

Won Y. Kim ◽

...

Keyword(s):

Type 2 Diabetes ◽

Cohort Study ◽

White Matter ◽

Arterial Stiffness ◽

White Matter Hyperintensities ◽

Cerebrovascular Diseases ◽

Study Data ◽

Cerebral White Matter ◽

Intracranial Volume

Abstract Background Stroke is a serious complication in patients with type 2 diabetes (T2DM). Arterial stiffness may improve stroke prediction. We investigated the association between carotid-femoral pulse wave velocity [PWV] and the progression of cerebral white matter hyperintensities (WMH), a marker of stroke risk, in patients with T2DM and controls. Methods In a 5-year cohort study, data from 45 patients and 59 non-diabetic controls were available for analysis. At baseline, participants had a mean (± SD) age of 59 ± 10 years and patients had a median (range) diabetes duration of 1.8 (0.8–3.2) years. PWV was obtained by tonometry and WMH volume by an automated segmentation algorithm based on cerebral T2-FLAIR and T1 MRI (corrected by intracranial volume, cWMH). High PWV was defined above 8.94 m/s (corresponding to the reference of high PWV above 10 m/s using the standardized path length method). Results Patients with T2DM had a higher PWV than controls (8.8 ± 2.2 vs. 7.9 ± 1.4 m/s, p < 0.01). WMH progression were similar in the two groups (p = 0.5). One m/s increase in baseline PWV was associated with a 16% [95% CI 1–32%], p < 0.05) increase in cWMH volume at 5 years follow-up after adjustment for age, sex, diabetes, pulse pressure and smoking. High PWV was associated with cWMH progression in the combined cohort (p < 0.05). We found no interaction between diabetes and PWV on cWMH progression. Conclusions PWV is associated with cWMH progression in patients with type 2 diabetes and non-diabetic controls. Our results indicate that arterial stiffness may be involved early in the pathophysiology leading to cerebrovascular diseases.

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High Prevalence of White Matter Hyperintensities in Normal Aging: Relation to Blood Pressure and Cognition

Cortex ◽

10.1016/s0010-9452(08)70879-7 ◽

2003 ◽

Vol 39 (4-5) ◽

pp. 1093-1105 ◽

Cited By ~ 70

Author(s):

H SODERLUND ◽

L NYBERG ◽

R ADOLFSSON ◽

L NILSSON ◽

L LAUNER

Keyword(s):

Blood Pressure ◽

White Matter ◽

White Matter Hyperintensities ◽

Normal Aging ◽

High Prevalence

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Development and validation of morphological segmentation of age-related cerebral white matter hyperintensities

NeuroImage ◽

10.1016/j.neuroimage.2009.03.055 ◽

2009 ◽

Vol 47 (1) ◽

pp. 199-203 ◽

Cited By ~ 31

Author(s):

Richard Beare ◽

Velandai Srikanth ◽

Jian Chen ◽

Thanh G. Phan ◽

Jennifer Stapleton ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Cerebral White Matter ◽

Morphological Segmentation ◽

Age Related ◽

Development And Validation

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Re: The Relationship between Cerebral White Matter Hyperintensities and Lower Urinary Tract Function in a Population Based, Geriatric Cohort

The Journal of Urology ◽

10.1016/j.juro.2014.07.048 ◽

2014 ◽

Vol 192 (4) ◽

pp. 1164-1165

Author(s):

Tomas L. Griebling

Keyword(s):

Urinary Tract ◽

White Matter ◽

Lower Urinary Tract ◽

White Matter Hyperintensities ◽

Population Based ◽

Cerebral White Matter ◽

Lower Urinary Tract Function ◽

Tract Function ◽

The Relationship ◽

Lower Urinary

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Cerebral white matter Hyperintensities in HIV–positive patients

Brain Imaging and Behavior ◽

10.1007/s11682-018-9966-1 ◽

2018 ◽

Vol 14 (1) ◽

pp. 10-18 ◽

Cited By ~ 2

Author(s):

Alice Trentalange ◽

Adolfo Prochet ◽

Daniele Imperiale ◽

Jessica Cusato ◽

Mariacristina Tettoni ◽

...

Keyword(s):

White Matter ◽

White Matter Hyperintensities ◽

Cerebral White Matter ◽

Hiv Positive

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Abstract TP442: Periventricular Not Deep White Matter Hyperintensities Are Associated With Vascular Cognitive Impairment

Stroke ◽

10.1161/str.48.suppl_1.tp442 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Yan Chen ◽

Renyuan Liu ◽

Shuwei Qiu ◽

Yun Xu

Keyword(s):

Regression Analysis ◽

Cognitive Impairment ◽

White Matter ◽

Linear Regression ◽

Cognitive Performance ◽

White Matter Hyperintensities ◽

Rating Scale ◽

Linear Regression Analysis ◽

Vascular Cognitive Impairment ◽

Cerebral White Matter

Introduction: Cerebral White matter hyperintensities(WMH) are frequent findings on MRI scan. They are well known to correlate with vascular cognitive impairment(VCI). However, controversies still remain about the relationship between WMH locations and cognitive function across studies. Hypothesis: Periventricular WMHs(PWH) rather than deep WMHs(DWH) are associated with cognitive decline in VCI. Methods: Fifty-nine subjects with WMHs on MRI were divided into three groups, normal control(NC), mild cognitive impairment(MCI) and vascular dementia(VaD), according to clinical manifestation and neuropsychological performance. WMH volumes were evaluated by Fazekas rating scale and segmental volumetric. Correlations between cognitive performance and WMH volumes were determined in virtue of Spearman correlation analysis. Receiver operator characteristic (ROC) curves were generated to define the classification cut-off value of WMH volumes for distinguishing VCI versus normal controls. Multiple linear regression analysis was used to predict cognitive performance with WMH volumes and locations after adjusting for sex ,age and education level. Results: Cognitive capacities were gradually declined from NC through MCI to VaD patients while WMH volumes and Fazekas scores altered oppositely. Both PWH and DWH volumes and Fazekas scores were correlated with cognitive performance, and moreover, WMH volumes were correlated with Fazekas scores. ROC analysis showed a cut-off value of PWH rather than DWH to distinguish VCI from NC(AUC=0.745 and 0.635, p =0.001 and 0.076, respectively). Linear regression analysis demonstrated that only PWH volumes were associated with cognitive performance( p < 0.001). Conclusion: Our study demonstrate that PWHs are independent predictors for vascular contribution in white matter lesions and suggest clinicians that PWH should be emphasized on evaluating vascular cognitive impairment related with white matter load.

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Volume of white matter hyperintensities increases with blood pressure in patients with hypertension

Journal of International Medical Research ◽

10.1177/0300060519858023 ◽

2019 ◽

Vol 47 (8) ◽

pp. 3681-3689 ◽

Cited By ~ 2

Author(s):

Yu Zhao ◽

Zunyu Ke ◽

Wenbo He ◽

Zhiyou Cai

Keyword(s):

Blood Pressure ◽

White Matter ◽

White Matter Hyperintensities ◽

Clinical Analysis ◽

Primary Diagnosis ◽

Mri Findings ◽

Scale Scores ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Fazekas Scale

Objective Hypertension is a risk factor for development of white matter hyperintensities (WMHs). However, the relationship between hypertension and WMHs remains obscure. We sought to clarify this relationship using clinical data from different regions of China. Methods We analyzed the data of 333 patients with WMHs in this study. All included patients underwent conventional magnetic resonance imaging (MRI) examination. A primary diagnosis of WMHs was made according to MRI findings. The volume burden of WMHs was investigated using the Fazekas scale, which is widely used to rate the degree of WMHs. We conducted retrospective clinical analysis of the data in this study. Results Our findings showed that WMHs in patients with hypertension were associated with diabetes, cardiovascular diseases, history of cerebral infarct, and plasma glucose and triglyceride levels. Fazekas scale scores for WMHs increased with increased blood pressure values in patients with hypertension. Conclusion This analysis indicates that hypertension is an independent contributor to the prevalence and severity of WMHs.

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