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Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe.

Abstract

BACKGROUND

Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small-vessel pathology, which contributes to cognitive decline in patients with AD. Alternatively, in persons with high blood pressure, increased numbers of neurofibrillary tangles and amyloid plaques at autopsy have also been observed, suggesting direct links between blood pressure and AD.

OBJECTIVE

To investigate the association of blood pressure and markers of small-vessel disease (white matter lesions [WMLs] on MRI) with hippocampal and amygdalar atrophy on MRI-potential in vivo indicators of Alzheimer pathology.

METHODS

In 1995 to 1996, 511 nondemented elderly subjects (age 60 to 90) underwent MRI. The extent of WMLs was assessed, and volumes of the hippocampus and amygdala were measured. Blood pressure levels were assessed at the time of MRI and 5 years before the MRI.

RESULTS

Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase -0.10 mL [95% CI -0.19 to -0.02, p = 0.02]). Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy. Persons with more WMLs on MRI more often had severe atrophy of the hippocampus and amygdala.

CONCLUSION

Blood pressure and indicators of small-vessel disease in the brain may be associated with atrophy of structures affected by Alzheimer pathology.

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  • Authors+Show Affiliations

    ,

    Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.

    , , , , , ,

    Source

    Neurology 64:2 2005 Jan 25 pg 263-7

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Alzheimer Disease
    Amygdala
    Antihypertensive Agents
    Arteriosclerosis
    Atrophy
    Blood Pressure
    Cephalometry
    Cohort Studies
    Comorbidity
    Diastole
    Female
    Follow-Up Studies
    Hippocampus
    Humans
    Hypertension
    Hypotension
    Magnetic Resonance Imaging
    Male
    Middle Aged
    Myelin Sheath
    Netherlands
    Temporal Lobe

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15668423

    Citation

    den Heijer, T, et al. "Association Between Blood Pressure, White Matter Lesions, and Atrophy of the Medial Temporal Lobe." Neurology, vol. 64, no. 2, 2005, pp. 263-7.
    den Heijer T, Launer LJ, Prins ND, et al. Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. Neurology. 2005;64(2):263-7.
    den Heijer, T., Launer, L. J., Prins, N. D., van Dijk, E. J., Vermeer, S. E., Hofman, A., ... Breteler, M. M. (2005). Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. Neurology, 64(2), pp. 263-7.
    den Heijer T, et al. Association Between Blood Pressure, White Matter Lesions, and Atrophy of the Medial Temporal Lobe. Neurology. 2005 Jan 25;64(2):263-7. PubMed PMID: 15668423.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. AU - den Heijer,T, AU - Launer,L J, AU - Prins,N D, AU - van Dijk,E J, AU - Vermeer,S E, AU - Hofman,A, AU - Koudstaal,P J, AU - Breteler,M M B, PY - 2005/1/26/pubmed PY - 2005/9/21/medline PY - 2005/1/26/entrez SP - 263 EP - 7 JF - Neurology JO - Neurology VL - 64 IS - 2 N2 - BACKGROUND: Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small-vessel pathology, which contributes to cognitive decline in patients with AD. Alternatively, in persons with high blood pressure, increased numbers of neurofibrillary tangles and amyloid plaques at autopsy have also been observed, suggesting direct links between blood pressure and AD. OBJECTIVE: To investigate the association of blood pressure and markers of small-vessel disease (white matter lesions [WMLs] on MRI) with hippocampal and amygdalar atrophy on MRI-potential in vivo indicators of Alzheimer pathology. METHODS: In 1995 to 1996, 511 nondemented elderly subjects (age 60 to 90) underwent MRI. The extent of WMLs was assessed, and volumes of the hippocampus and amygdala were measured. Blood pressure levels were assessed at the time of MRI and 5 years before the MRI. RESULTS: Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase -0.10 mL [95% CI -0.19 to -0.02, p = 0.02]). Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy. Persons with more WMLs on MRI more often had severe atrophy of the hippocampus and amygdala. CONCLUSION: Blood pressure and indicators of small-vessel disease in the brain may be associated with atrophy of structures affected by Alzheimer pathology. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/15668423/Association_between_blood_pressure_white_matter_lesions_and_atrophy_of_the_medial_temporal_lobe_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&pmid=15668423 DB - PRIME DP - Unbound Medicine ER -