Lower Blood Pressure Is Associated With Smaller Subcortical Brain Volumes in Older Persons

Am J Hypertens. 2015 Sep;28(9):1127-33. doi: 10.1093/ajh/hpv006. Epub 2015 Feb 24.

Abstract

Background: Both high and low blood pressure (BP) have been positively as well as negatively associated with brain volumes in a variety of populations. The objective of this study was to investigate whether BP is associated with cortical and subcortical brain volumes in older old persons with mild cognitive deficits.

Methods: Within the Discontinuation of Antihypertensive Treatment in the Elderly trial, the cross-sectional relation of BP parameters with both cortical and subcortical brain volumes was investigated in 220 older old persons with mild cognitive deficits (43% men, mean age = 80.7 (SD = 4.1), median Mini-Mental State Examination score = 26 (interquartile range: 25-27)), using linear regression analysis. All analyses were adjusted for age, gender, volume of white matter hyperintensities, and duration of antihypertensive treatment. Brain volumes were determined on 3DT1-weighted brain magnetic resonance imaging scans.

Results: Lower systolic BP, diastolic BP, and mean arterial pressure (MAP) were significantly associated with lower volumes of thalamus and putamen (all P ≤ 0.01). In addition, lower MAP was also associated with reduced hippocampal volume (P = 0.035). There were no associations between any of the BP parameters with cortical gray matter or white matter volume.

Conclusion: In an older population using antihypertensive medication with mild cognitive deficits, a lower BP, rather than a high BP is associated with reduced volumes of thalamus, putamen, and hippocampus.

Keywords: blood pressure; brain; cross-sectional study; elderly; hypertension; magnetic resonance imaging..

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / adverse effects
  • Arterial Pressure
  • Blood Pressure* / drug effects
  • Brain / pathology*
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / pathology*
  • Cognitive Dysfunction / physiopathology
  • Cross-Sectional Studies
  • Drug Administration Schedule
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy
  • Hypertension / physiopathology*
  • Leukoencephalopathies / etiology
  • Leukoencephalopathies / pathology*
  • Leukoencephalopathies / physiopathology
  • Magnetic Resonance Imaging
  • Male
  • Netherlands
  • Protective Factors
  • Psychiatric Status Rating Scales
  • Risk Factors

Substances

  • Antihypertensive Agents