A regular discovery in older people’s cerebral magnetic resonance imaging (MRI) is the white matter hyperintensities (WMH) of presumed vascular origin. WMH are credited to small vessel disease and they are involved in cognitive decline’s pathogenesis. People may become vulnerable to small vessel disease due to several vascular risk factors, particularly arterial hypertension. Thus, researchers analyzed the correlation between antihypertensive medication, systolic blood pressure (SBP), and diastolic blood pressure (DBP) with WMH volume in 560 participants. Those participants were part of the 1000 BRAINS study. It is extracted from the population-based Heinz Nixdorf Recall study (65.2±7.5 years; 51.4% men).
In addition, the researchers also scrutinized the effectiveness of the treatment by classifying 6 BP treatment groups, which were categorized by antihypertensive medicines and BP levels. The groups are – (1) untreated BP, where SBP and DBP are less than 120 or 80 mm Hg respectively (2) untreated SBP 120-139 or DBP 80-89 mm Hg, (3) untreated BP, where SBP is greater than or equal to 140 mm Hg or DBP is greater than or equal to 90 mm Hg, (4) treated BP, where SBP and DBP are less than 120 or 80 mm Hg respectively, (5) treated SBP 120-139 or DBP 80-89 mm Hg, and (6) treated BP, where SBP is greater than or equal to 140 mm Hg or DBP is greater than or equal to 90 mm Hg.
The median WMH volume for (Q1-Q3) was 4.6 (3.0–7.8) cm3. The mean±SD of SBP and DBP was (128.6±17.4) and (76.1±9.8) mm Hg respectively. In multivariable linear regression models, the researchers found significant link between WMH volumes with continuous SBP (β=0.63 cm3 per 10 mm Hg [95% CI, 0.32–0.94]), DBP (0.64 cm3 per 5 mmHg [95% CI, 0.37–0.91]), and antihypertensive treatment (1.23 cm3 [95% CI, 0.14–2.23]). As for the effectiveness of the treatment, there was a significant increase in WMH volume (4.24 cm3 [2.36–6.13]) was seen only in participants with hypertension despite treatment (treated BP ≥140 or ≥90 mm Hg) relative to normotension without treatment (untreated BP <120/<80 mm Hg). The outcomes proposed that WMHs signify a marker of advanced hypertension pathology. As such, WMHs can be prevented through early treatment.
Link:www.ahajournals.org/doi/full/10.1161/HYPERTENSIONAHA.121.18135
