Midlife Hypertension Affects Brain Pathology Later in Life

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Correlation of late-life BP to brain measures dependent on midlife hypertension history.
Correlation of late-life BP to brain measures dependent on midlife hypertension history.

For older men and women without dementia, the impact of late-life blood pressure on brain pathology varies with their history of midlife hypertension, according to a study published online June 4 in Neurology.

Majon Muller, M.D., Ph.D., from the National Institute of Aging in Bethesda, Md., and colleagues examined the correlation between late-life blood pressure and brain pathology in a study involving 4,057 older men and women without dementia. Participants had midlife and late-life vascular screening, cognitive function, and brain structures ascertained on magnetic resonance imaging.

The researchers found that the correlation between late-life blood pressure and brain measures was dependent on history of midlife hypertension.

The risk of white matter lesions and cerebral microbleeds was increased in association with higher late-life systolic and diastolic blood pressure, and this was most pronounced for those without a history of midlife hypertension. Lower late-life diastolic blood pressure was associated with smaller total brain and gray matter volumes for participants with a history of midlife hypertension. Lower diastolic blood pressure correlated with lower memory scores in participants with midlife hypertension.

"In this large population-based cohort, late-life blood pressure differentially affects brain pathology and cognitive performance, depending on the history of midlife hypertension," the authors write. "Our study suggests history of hypertension is critical to understand how late-life blood pressure affects brain structure and function."

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