MRI ‐Based Investigation of Association Between Cerebrovascular Structural Alteration and White Matter Hyperintensity Induced by High Blood Pressure

2021 ◽  
Author(s):  
Boyu Zhang ◽  
Yingzhe Wang ◽  
Bei Wang ◽  
Ying‐Hua Chu ◽  
Yanfeng Jiang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
High Blood Pressure ◽  
Structural Alteration ◽  
White Matter Hyperintensity

Abstract P622: Racial Variation in White Matter Hyperintensity Progression in the ACCORDION MIND Study

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Alison L Herman ◽  
Adam H De Havenon ◽  
Guido J Falcone ◽  
Shadi Yaghi ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Systolic Blood Pressure ◽  
White Matter Hyperintensity ◽  
Diabetic Patients ◽  
Patient Race ◽  
Black Patients ◽  
The Mean ◽  
White Patients

Introduction: White matter hyperintensities (WMH) are linked to cognitive decline and stroke. We hypothesized that Black race would be associated with greater WMH progression in the ACCORDION MIND trial. Methods: The primary outcome is WMH progression in mL, evaluated by fitting linear regression to WMH volume on the month 80 MRI and including the WMH volume on the baseline MRI. The primary predictor is patient race, with the exclusion of patients defined as “other” race. We also derived predicted probabilities of our outcome for systolic blood pressure (SBP) levels. Results: We included 276 patients who completed the baseline and month 80 MRI, of which 207 were white, 48 Black, and 21 Hispanic. During follow-up, the mean number of SBP, LDL, and A1c measurements per patient was 21, 8, and 15. The mean (SD) WMH progression was 3.3 (5.4) mL for blacks, 2.5 (3.2) mL for Hispanics, and 2.4 (3.3) mL for whites. In the multivariate regression model (Table 1), Black, compared to white, patients had significantly more WMH progression (β Coefficient 1.26, 95% CI 0.45-2.06, p=0.002). Hispanic, compared to white, patients did not have significantly different WMH progression (p=0.392), nor was there a difference when comparing Hispanic to Black patients (p=0.162). The predicted WMH progression was significantly higher for Black compared to white patients across a mean SBP of 117 to 139 mm Hg (Figure 1). Conclusions: Black diabetic patients in ACCORDION MIND have a higher risk of WMH progression than white patients across a normal range of systolic blood pressure.

Abstract 141: Systolic Blood Pressure and White Matter Hyperintensity Progression in ACCORD-MIND

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Jennifer J Majersik ◽  
David Tirschwell ◽  
J Scott McNally ◽  
Natalia Rost
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Systolic Blood Pressure ◽  
White Matter Hyperintensity

Blood Pressure and White Matter Hyperintensity Volume - A Review of the Relationship and Implications for Stroke Prediction and Prevention

2012 ◽  
Vol 7 (3) ◽  
pp. 174 ◽  
Author(s):  
Royya Modir ◽  
Hannah Gardener ◽  
Clinton B Wright ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
White Matter ◽  
Large Population ◽  
Brain Perfusion ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Population Based ◽  
White Matter Hyperintensity ◽  
Prediction And Prevention

A heavy burden of white matter hyperintensities (WMH) is a risk factor for stroke and vascular cognitive impairment making it important to understand their pathophysiology, aetiology and clinical implications. Ageing studies suggest a linear relationship between blood pressure (BP) and both WMH and microstructural integrity in normal-appearing white matter and, after age, hypertension is the strongest risk factor for WMH. Numerous large population-based observational studies have reported significant associations between elevated BP and WMH burden, however, the relative importance of systolic versus diastolic BP remains controversial. Limitations of prior studies include the use of only a single measurement of BP and oversimplifying hypertension as a dichotomous variable. Race/ethnic differences in the association between BP and WMH have been suggested, but most studies only included older Caucasians. Antihypertensive treatment has been demonstrated to slow WMH progression, but lowering BP in the elderly may also reduce brain perfusion in those with poor autoregulation. Ongoing trials aim to clarify the effects of BP treatment on WMH progression in multi-ethnic populations and the implications of these findings for stroke prevention require further study.

scholarly journals High Blood Pressure and Cerebral White Matter Lesion Progression in the General Population

Hypertension ◽  
2013 ◽  
Vol 61 (6) ◽  
pp. 1354-1359 ◽  
Author(s):  
Benjamin F.J. Verhaaren ◽  
Meike W. Vernooij ◽  
Renske de Boer ◽  
Albert Hofman ◽  
Wiro J. Niessen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
General Population ◽  
High Blood Pressure ◽  
White Matter Lesion ◽  
Cerebral White Matter ◽  
Cerebral White Matter Lesion

scholarly journals Baseline and Longitudinal Increases in Diastolic Blood Pressure Are Associated With Greater White Matter Hyperintensity Volume

Stroke ◽  
2011 ◽  
Vol 42 (9) ◽  
pp. 2639-2641 ◽  
Author(s):  
Justin Marcus ◽  
Hannah Gardener ◽  
Tatjana Rundek ◽  
Mitchell S.V. Elkind ◽  
Ralph L. Sacco ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
White Matter Hyperintensity

Brain atrophy and white matter hyperintensity change in older adults and relationship to blood pressure

2007 ◽  
Vol 254 (6) ◽  
pp. 713-721 ◽  
Author(s):  
Michael J. Firbank ◽  
Rebecca M. Wiseman ◽  
Emma J. Burton ◽  
Brian K. Saxby ◽  
John T. O’Brien ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
White Matter ◽  
Brain Atrophy ◽  
White Matter Hyperintensity

Blood Pressure and White Matter Hyperintensity Volume - A Review of the Relationship and Implications for Stroke Prediction and Prevention

2012 ◽  
Vol 7 (4) ◽  
pp. 224
Author(s):  
Royya Modir ◽  
Hannah Gardener ◽  
Clinton B Wright ◽  
◽  
◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
White Matter ◽  
Large Population ◽  
Brain Perfusion ◽  
The Elderly ◽  
Vascular Cognitive Impairment ◽  
Population Based ◽  
White Matter Hyperintensity ◽  
Prediction And Prevention

A heavy burden of white matter hyperintensities (WMH) is a risk factor for stroke and vascular cognitive impairment making it important to understand their pathophysiology, aetiology and clinical implications. Ageing studies suggest a linear relationship between blood pressure (BP) and both WMH and microstructural integrity in normal-appearing white matter and, after age, hypertension is the strongest risk factor for WMH. Numerous large population-based observational studies have reported significant associations between elevated BP and WMH burden, however, the relative importance of systolic versus diastolic BP remains controversial. Limitations of prior studies include the use of only a single measurement of BP and oversimplifying hypertension as a dichotomous variable. Race/ethnic differences in the association between BP and WMH have been suggested, but most studies only included older Caucasians. Antihypertensive treatment has been demonstrated to slow WMH progression, but lowering BP in the elderly may also reduce brain perfusion in those with poor autoregulation. Ongoing trials aim to clarify the effects of BP treatment on WMH progression in multi-ethnic populations and the implications of these findings for stroke prevention require further study.

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