scholarly journals Association of Low Blood Pressure with White Matter Hyperintensities in Elderly Individuals with Controlled Hypertension

2020 ◽  
Vol 22 (1) ◽  
pp. 99-107
Author(s):  
Jun Sung Kim ◽  
Subin Lee ◽  
Seung Wan Suh ◽  
Jong Bin Bae ◽  
Ji Hyun Han ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
White Matter Hyperintensities ◽  
Community Dwelling ◽  
White Matter Hyperintensity ◽  
Periventricular White Matter ◽  
Elderly Individuals ◽  
Low Blood Pressure

Background and Purpose Both hypertension and hypotension increase cerebral white matter hyperintensities. However, the effects of hypotension in individuals with treated hypertension are unknown. We analyzed the association of low blood pressure with the location and amount of white matter hyperintensities between elderly individuals with controlled hypertension and those without hypertension.Methods We enrolled 505 community-dwelling, cognitively normal elderly individuals from the participants of the Korean Longitudinal Study on Cognitive Aging and Dementia. We measured blood pressure three times in a sitting position using a mercury sphygmomanometer and defined low systolic and diastolic blood pressure as ≤110 and ≤60 mm Hg, respectively. We segmented and quantified the periventricular and deep white matter hyperintensities from 3.0 Tesla fluid-attenuated inversion recovery magnetic resonance images.Results Low systolic blood pressure was independently associated with larger volume of periventricular white matter hyperintensity (<i>P</i>=0.049). The interaction between low systolic blood pressure and hypertension was observed on the volume of periventricular white matter hyperintensity (<i>P</i>=0.005). Low systolic blood pressure was associated with the volume of periventricular white matter hyperintensity in individuals with controlled hypertension (F<sub>1,248</sub>=6.750, <i>P</i>=0.010), but not in those without hypertension (<i>P</i>=0.380). Low diastolic blood pressure was not associated with the volumes of white matter hyperintensities regardless of presence of controlled hypertension.Conclusions Low systolic blood pressure seems to be associated with larger volume of periventricular white matter hyperintensity in the individuals with a historyof hypertension but not in those without hypertension.

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

scholarly journals Internal Bleaching of a Non vital Anterior Tooth in Patient with Postural Hypotension

2020 ◽  
Vol 23 (2) ◽  
pp. 45-50
Author(s):  
Ramadhani Putri Salicha ◽  
Kun Ismiyatin ◽  
Pramita Tanjung Sari ◽  
Olivia Vivian Widjaja ◽  
Ria Puspita Sari
Keyword(s):  
Blood Pressure ◽  
Hydrogen Peroxide ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Postural Hypotension ◽  
Clinical Case ◽  
Anterior Tooth ◽  
Central Incisor ◽  
Low Blood Pressure

Postural hypotension is a form of low blood pressure, characterized a 20 mmHg decrease in systolic blood pressure or a 10 mmHg drop in diastolic blood pressure when rising from a sitting or lying position. This can cause syncope. A patient who comes to a dentist with postural hypotension may be a tough case. A 48-year-old woman arrived with postural hypotension and felt dissatisfied with the discolored and unsightly condition of her upper central incisor. This clinical case shows a management of postural hypotension patient in internal bleaching technique on non-vital teeth using 35% hydrogen peroxide. This therapy is simple, safety and adequate for patients who has postural hypotension with satisfactory results.

Progression of cerebral white matter hyperintensities on MRI is related to diastolic blood pressure

Neurology ◽  
1998 ◽  
Vol 51 (1) ◽  
pp. 319-320 ◽  
Author(s):  
J. H. Veldink ◽  
P. Scheltens ◽  
C. Jonker ◽  
L. J. Launer
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Diastolic Blood Pressure ◽  
White Matter Hyperintensities ◽  
Cerebral White Matter

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

White matter hyperintensities in migraine: Clinical significance and central pulsatile hemodynamic correlates

Cephalalgia ◽  
2017 ◽  
Vol 38 (7) ◽  
pp. 1225-1236 ◽  
Author(s):  
Chun-Yu Cheng ◽  
Hao-Min Cheng ◽  
Shih-Pin Chen ◽  
Chih-Ping Chung ◽  
Yung-Yang Lin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
White Matter ◽  
Pulse Wave Velocity ◽  
Systolic Blood Pressure ◽  
Wave Velocity ◽  
Pulsatility Index ◽  
White Matter Hyperintensities ◽  
Pulse Wave ◽  
Healthy Controls ◽  
Central Systolic Blood Pressure

Background The role of central pulsatile hemodynamics in the pathogenesis of white matter hyperintensities in migraine patients has not been clarified. Methods Sixty patients with migraine (20–50 years old; women, 68%) without overt vascular risk factors and 30 demographically-matched healthy controls were recruited prospectively. Cerebral white matter hyperintensities volume was determined by T1-weighted magnetic resonance imaging with CUBE-fluid-attenuated-inversion-recovery sequences. Central systolic blood pressure, carotid-femoral pulse wave velocity, and carotid augmentation index were measured by applanation tonometry. Carotid pulsatility index was derived from Doppler ultrasound carotid artery flow analysis. Results Compared to the controls, the migraine patients had higher white matter hyperintensities frequency (odds ratio, 2.75; p = 0.04) and greater mean white matter hyperintensities volume (0.174 vs. 0.049, cm3, p = 0.04). Multivariable regression analysis showed that white matter hyperintensities volume in migraine patients was positively associated with central systolic blood pressure ( p = 0.04) and carotid-femoral pulse wave velocity ( p < 0.001), but negatively associated with carotid pulsatility index ( p = 0.04) after controlling for potential confounding factors. The interaction effects observed indicated that the influence of carotid-femoral pulse wave velocity ( p = 0.004) and central systolic blood pressure ( p = 0.03) on white matter hyperintensities formation was greater for the lower-carotid pulsatility index subgroup of migraine patients. White matter hyperintensities volume in migraine patients increased with decreasing carotid pulsatility index and with increasing central systolic blood pressure or carotid-femoral pulse wave velocity. Conclusions White matter hyperintensities are more common in patients with migraine than in healthy controls. Increased aortic stiffness or central systolic blood pressure in the presence of low intracranial artery resistance may predispose patients with migraine to white matter hyperintensities formation.

scholarly journals Cortical thickness, white matter hyperintensities, and cognition after stroke

2019 ◽  
Vol 15 (1) ◽  
pp. 46-54 ◽  
Author(s):  
David Alexander Dickie ◽  
Kirstyn Gardner ◽  
Annika Wagener ◽  
Annick Wyss ◽  
Francesco Arba ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Cortical Thickness ◽  
Mental State ◽  
White Matter Hyperintensities ◽  
Mini Mental State Examination ◽  
Community Dwelling ◽  
White Matter Hyperintensity ◽  
Pairwise Correlation ◽  
State Examination

Background A thinner cerebral cortex is associated with higher white matter hyperintensity burden and cognitive impairment in community-dwelling and dementia cohorts. It is important to assess these associations in people with ischemic stroke because their cerebrovascular disease profiles are different to these cohorts. Aims We aimed to determine whether cortical thickness was related to white matter hyperintensity burden and cognition after ischemic stroke. Methods We measured cortical thickness using advanced normalization tools' “KellyKapowski” function in 244 patients with ischemic stroke or transient ischemic attack from the Virtual International Stroke Trials Archive. We measured white matter hyperintensity burden via quantitative volumes and Fazekas score. We extracted data on vascular risk factors at baseline and Mini Mental State Examination scores at one year. We assessed associations between imaging and clinical data using correlation and multiple linear regression. Results Pairwise correlation showed that higher white matter hyperintensity Fazekas score was associated with a thinner cortex (rho = −0.284, P < 0.0001). White matter hyperintensities were generally distributed adjacent to and above the lateral ventricles. Voxel-wise analyses showed statistically significant negative associations between cortical thickness and white matter hyperintensities across fronto-temporal and inferior parietal cortical regions. Mean cortical thickness was positively related to Mini Mental State Examination in pair-wise correlation (r = 0.167, P = 0.0088) but there was no independent association after adjustment for age and white matter hyperintensities (beta = 0.016, P = 0.7874). Conclusions Cortical thickness was not an independent predictor of cognition after ischemic stroke. Further work is required to understand how white matter hyperintensities are associated with a thinner cortex in temporal regions but less so in more superior regions where white matter hyperintensities are generally found in people with stroke.

scholarly journals Strong and specific associations between cardiovascular risk factors and brain white matter micro- and macro-structure in health ageing

2018 ◽  
Author(s):  
Delia Fuhrmann ◽  
David Nesbitt ◽  
Meredith Shafto ◽  
James B. Rowe ◽  
Darren Price ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Rate ◽  
Cardiovascular Risk ◽  
White Matter ◽  
Systolic Blood Pressure ◽  
Cardiovascular Risk Factors ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Health ◽  
Brain White Matter

AbstractCardiovascular health declines with age, increasing the risk of hypertension and elevated heart rate in middle- and old age. Here, we used multivariate techniques to investigate the associations between cardiovascular health (diastolic blood pressure, systolic blood pressure and heart rate) and white matter macrostructure (lesion volume and number), and microstructure (as measured by Diffusion Weighted Imaging) in the cross-sectional, population-based Cam-CAN cohort (N = 667, aged 18 to 88). We found that cardiovascular health and age made approximately similar contributions to white matter health and explained up to 56% of variance. Lower diastolic blood pressure, higher systolic blood pressure and higher heart rate were each strongly, and independently, associated with white matter abnormalities on all indices. Body mass and exercise were associated with white matter health, both directly and indirectly via cardiovascular health. These results highlight the importance of cardiovascular risk factors for white matter health across the adult lifespan and suggest that systolic blood pressure, diastolic blood pressure and heart rate affect white matter via separate mechanisms.

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