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Neurology. 2005 Jun 14;64(11):1846-52.

Ambulatory blood pressure and the brain: a 5-year follow-up.

Author information

  • 1Department of Psychiatry, University of California, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA. irisg@ucla.edu

Abstract

OBJECTIVE:

To determine if initial values of casual and ambulatory systolic blood pressure (SBP) predict white matter hyperintensities, insular subcortex hyperintensities, and brain atrophy 5 years later in a group of healthy elderly individuals.

METHODS:

The authors studied 155 healthy men and women, aged 55 to 79 years. Two 24-hour ambulatory blood pressure (BP) sessions assessed BP level and variability during waking and sleep. Hyperintensities and total brain volume were quantified by MRI. Procedures were repeated 5 years later in 78% (121) of subjects.

RESULTS:

Hyperintensities and brain atrophy increased over time, with greater increases among older subjects. The presence of increased BP level and variability initially and again 5 years later had negative consequences for the brain. Independent of age, the greater the initial SBP, the greater the likelihood that individuals would have severe white matter hyperintensities after 5 years. Also, elevated casual SBP was associated with severe insular subcortex hyperintensities and greater SBP sleep variability with increased brain atrophy.

CONCLUSIONS:

Among healthy elderly individuals whose initial, average, casual blood pressure (BP) was relatively low (116.9/71.1 mm Hg), small increases in casual and 24-hour ambulatory BP measures were associated with greater brain atrophy and subcortical lesions after 5 years.

Comment in

PMID:
15955932
[PubMed - indexed for MEDLINE]
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