Ambulatory Systolic BP Tied to White Matter Hyperintensity

Increased ambulatory systolic BP also linked to measures of executive function/processing speed

WEDNESDAY, Nov. 23 (HealthDay News) -- Among older individuals, ambulatory systolic blood pressure (BP), but not clinic BP, is associated with longitudinal progression of white matter hyperintensity (WMH) volume, according to a study published in the Nov. 22 issue of Circulation.

William B. White, M.D., from the University of Connecticut School of Medicine in Farmington, and colleagues examined the relationships between ambulatory and clinic BP, progression of WMH volume, and functional capabilities in 72 individuals aged 75 to 89 years. Participants underwent ambulatory and clinic BP monitoring, magnetic resonance imaging, gait studies, and neuropsychological testing at baseline and after 24 months. Semiautomated segmentation was performed to classify brain into normal white matter and T2-hyperintense WMH volume. Longitudinal analyses quantitatively measured mobility and cognitive function.

The investigators found that an increase in ambulatory systolic BP from baseline to 24 months correlated with an increase in WMH volume, and with measures of executive function/processing speed. The 24-hour BP, awake BP, and sleep BP showed similar associations over the 24-month follow-up period. However, neither the clinic systolic BP, nor the surge in BP between the sleep and awake time, showed these correlations.

"These data demonstrate for the first time the importance of 24-hour systolic BP in the progression of brain white matter hyperintensity volume burden associated with impairment of cognitive function in older people," the authors write.

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