Blood pressure, internal carotid artery flow parameters, and age-related white matter hyperintensities

Benjamin S Aribisala, Zoe Morris, Elizabeth Eadie, Avril Thomas, Alan Gow, Maria C Valdés Hernández, Natalie A Royle, Mark E Bastin, John Starr, Ian J Deary, Joanna M Wardlaw

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    66 Citations (Scopus)

    Abstract

    White matter hyperintensities (WMH) are associated with hypertension. We examined interactions among blood pressure (BP), internal carotid artery (ICA) flow velocity parameters, and WMH. We obtained BP measurements from 694 community-dwelling subjects at mean ages 69.6 (±0.8) years and again at 72.6 (±0.7) years, plus brain MRI and ICA ultrasound at age 73±1 years. Diastolic and mean BP decreased and pulse pressure increased, but systolic BP did not change between 70 and 73 years. Multiple linear regression, corrected for vascular disease and risk factors, showed that WMH at the age of 73 years were associated with history of hypertension (β=0.13; P<0.001) and with BP at the age of 70 years (systolic β=0.08, mean β=0.09, diastolic β=0.08; all P<0.05); similar but attenuated associations were seen for BP at the age of 73 years. Lower diastolic BP and higher pulse pressure were associated with higher ICA pulsatility index at the age 73 years (diastolic BP age 70 years: standardized β=-0.24, P<0.001; pulse pressure age 70 years: β=0.19, P<0.001). WMH were associated with higher ICA pulsatility index (β=0.13; P=0.002) after adjusting for BP and correction for multiple testing. Therefore, falling diastolic BP and increased pulse pressure are associated with increased ICA pulsatility index, which in turn is associated with WMH. This suggests that hypertension and WMH may either associate indirectly because hypertension increases arterial stiffness that leads to WMH over time, or coassociate through advancing age and stiffer vessels, or both. Reducing vascular stiffness may reduce WMH progression and should be tested in randomized trials, in addition to testing antihypertensive therapy.

    Original languageEnglish
    Pages (from-to)1011-8
    Number of pages8
    JournalHypertension
    Volume63
    Issue number5
    DOIs
    Publication statusPublished - May 2014

    Keywords

    • Aged
    • Aging
    • Blood Pressure
    • Brain
    • Carotid Artery, Internal
    • Cohort Studies
    • Echoencephalography
    • Female
    • Humans
    • Hypertension
    • Linear Models
    • Longitudinal Studies
    • Magnetic Resonance Imaging
    • Male
    • Nerve Fibers, Myelinated
    • Regional Blood Flow
    • Retrospective Studies
    • Ultrasonography, Doppler

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