Selective vulnerability of medial temporal regions to short-term blood pressure variability and cerebral hypoperfusion in older adults

Sible, Isabel J.; Yew, Belinda; Dutt, Shubir; Li, Yanrong; Blanken, Anna E.; Jang, Jung Yun; Ho, Jean K.; Marshall, Amy; Kapoor, Arunima; Gaubert, Aimée; Bangen, Katherine J.; Sturm, Virginia E.; Shao, Xingfeng; Wang, Danny J.J.; Nation, Daniel A.

doi:10.1016/j.ynirp.2022.100080

Cited by 13 publications

(26 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Findings suggest elevated BPV over a period of a few minutes is associated with plasma AD biomarker levels in a sample of community-dwelling older adults, independent of average BP levels. Results are consistent with growing evidence that BPV may be a useful marker of vascular dysfunction related to AD [5][6][7][8][9][10]15,[19][20][21][24][25][26][27][28] . Findings add to previous studies on BPV using CSF 21 and PET 20 AD biomarkers.…”

Section: Discussionsupporting

confidence: 88%

“…Sensitivity analyses tested the robustness of findings by controlling for (1) Fazekas score, (2) DRS-2 scaled total score, (3) years of education, (4) BMI, and (5) antihypertensive medication use (see Supplementary Materials). These are commonly used covariates in other BPV studies 8,14,25 and were entered one at a time into regression models. Systolic BPV findings are reported in the main text and diastolic findings are reported in Supplementary Materials.…”

Section: Discussionmentioning

confidence: 99%

“…BP was collected continuously using a Biopac® BP monitoring device during a 5-min resting period in which participants were in the supine position. Data were processed offline using a custom pipeline scripted in AcqKnowledge® that excluded outliers and instances of noise (e.g., signal dropout due to sensor interference), as described elsewhere 25 . Intraindividual BPV was calculated as variation independent of mean (VIM), a commonly used measure of BPV uncorrelated with mean BP levels 7,24,26,[57][58][59] .…”

Section: Methodsmentioning

confidence: 99%

“…Ratios were determined for Ptau 181 :Aβ www.nature.com/scientificreports/ White matter hyperintensity assessment. Nearly all participants (n = 53 out of 54) also underwent T2-fluid attenuated inversion recovery (FLAIR) MRI sequence for the evaluation of white matter lesions, as previously described 25 . Briefly, the following imaging parameters were used: TR = 10,000 ms; TE = 91 ms; TI = 2500 ms; slice thickness = 5.0 mm; flip angle = 150°; field of view = 220 mm.…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Sible

Yew

Jang

et al. 2022

Sci Rep

View full text Add to dashboard Cite

Blood pressure variability is an emerging risk factor for Alzheimer’s disease in older adults, independent of average blood pressure levels. Growing evidence suggests increased blood pressure variability is linked to Alzheimer’s disease pathophysiology indexed by cerebrospinal fluid and positron emission tomography markers, but relationships with plasma Alzheimer’s disease markers have not been investigated. In this cross-sectional study of 54 community-dwelling older adults (aged 55–88, mean age 69.9 [8.2 SD]), elevated blood pressure variability over 5 min was associated with lower levels of plasma Aβ1–42 (standardized ß = − 0.36 [95% CI − 0.61, − 0.12]; p = 0.005; adjusted R2 = 0.28) and Aβ1–42: Aβ1–40 ratio (ß = − 0.49 [95% CI − 0.71, − 0.22]; p < 0.001; adjusted R2 = 0.28), and higher levels of total tau (ß = 0.27 [95% CI 0.01, 0.54]; p = 0.04; adjusted R2 = 0.19) and Ptau181:Aβ1–42 ratio (ß = 0.26 [95% CI 0.02, 0.51]; p = 0.04; adjusted R2 = 0.22). Findings suggest higher blood pressure variability is linked to plasma biomarkers of increased Alzheimer’s disease pathophysiology.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Sible

Yew

Jang

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Beat-to-beat blood pressure measurements were obtained continuously during resting state fMRI scan with participants in the supine position using an MRI compatible device (Biopac®). Data were processed with a custom pipeline scripted in AcqKnowledge® that excluded outliers and instances of noise (e.g., signal dropout due to sensor interference), as described elsewhere (35). Systolic blood pressure (SBP) readings were then averaged over 5 minutes of recording, and intraindividual BPV was calculated as variability independent of mean (VIM), a commonly used index of BPV that is uncorrelated with average BP (36)(37)(38).…”

Section: Blood Pressure Assessmentmentioning

confidence: 99%

Blood pressure variability, central autonomic network dysfunction and cerebral small vessel disease in APOE4 carriers

Lohman,

Sible,

Kapoor

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

BackgroundIncreased blood pressure variability (BPV) is a risk factor for cerebral small vessel disease (CSVD) and neurodegeneration, independent of age and average blood pressure, particularly in apolipoprotein E4 (APOE4) carriers. However, it remains uncertain whether BPV elevation is a cause or a consequence of vascular brain injury, or to what degree injury to the central autonomic network (CAN) may contribute to BPV-associated risk inAPOE4carriers.MethodsIndependently living older adults (n=70) with no history of stroke or dementia were recruited from the community and underwent 5 minutes of resting beat-to-beat blood pressure monitoring, genetic testing, and brain MRI. Resting BPV,APOEgenotype, CSVD burden on brain MRI, and resting state CAN connectivity by fMRI were analyzed. Causal mediation and moderation analysis evaluated BPV and CAN effects on CSVD inAPOE4carriers (n=37) and non-carriers (n=33).ResultsHigher BPV was associated with the presence and extent of CSVD inAPOE4carriers, but not non-carriers, independent of CAN connectivity (B= 18.92,P= .02), and CAN connectivity did not mediate the relationship between BPV and CSVD. InAPOE4carriers, CAN connectivity moderated the relationship between BPV and CSVD, whereby BPV effects on CSVD were greater in those with lower CAN connectivity (B= 36.43,P= .02).ConclusionsOlderAPOE4carriers with higher beat-to-beat BPV exhibit more extensive CSVD, independent of average blood pressure, and the strength of CAN connectivity does not mediate these effects. Findings suggest increased BPV is more likely a cause, not a consequence, of CSVD. BPV is more strongly associated with CSVD inAPOE4carriers with lower rsCAN connectivity, suggesting CAN dysfunction and BPV elevation may have synergistic effects on CSVD. Further studies are warranted to understand the interplay between BPV and CAN function inAPOE4carriers.

show abstract

Beat-to-beat blood pressure variability, hippocampal atrophy, and memory impairment in older adults

Lohman,

Sible,

Engstrom

et al. 2024

GeroScience

View full text Add to dashboard Cite

Visit-to-visit blood pressure variability (BPV) predicts age-related hippocampal atrophy, neurodegeneration, and memory decline in older adults. Beat-to-beat BPV may represent a more reliable and efficient tool for prospective risk assessment, but it is unknown whether beat-to-beat BPV is similarly associated with hippocampal neurodegeneration, or with plasma markers of neuroaxonal/neuroglial injury. Independently living older adults without a history of dementia, stroke, or other major neurological disorders were recruited from the community (N = 104; age = 69.5 ± 6.7 (range 55–89); 63% female). Participants underwent continuous blood pressure monitoring, brain MRI, venipuncture, and cognitive testing over two visits. Hippocampal volumes, plasma neurofilament light, and glial fibrillary acidic protein levels were assessed. Beat-to-beat BPV was quantified as systolic blood pressure average real variability during 7-min of supine continuous blood pressure monitoring. The cross-sectional relationship between beat-to-beat BPV and hippocampal volumes, cognitive domain measures, and plasma biomarkers was assessed using multiple linear regression with adjustment for demographic covariates, vascular risk factors, and average systolic blood pressure. Elevated beat-to-beat BPV was associated with decreased left hippocampal volume (P = .008), increased plasma concentration of glial fibrillary acidic protein (P = .006), and decreased memory composite score (P = .02), independent of age, sex, average systolic blood pressure, total intracranial volume, and vascular risk factor burden. In summary, beat-to-beat BPV is independently associated with decreased left hippocampal volume, increased neuroglial injury, and worse memory ability. Findings are consistent with prior studies examining visit-to-visit BPV and suggest beat-to-beat BPV may be a useful marker of hemodynamic brain injury in older adults.

show abstract

Selective vulnerability of medial temporal regions to short-term blood pressure variability and cerebral hypoperfusion in older adults

Cited by 13 publications

References 70 publications

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Blood pressure variability, central autonomic network dysfunction and cerebral small vessel disease in APOE4 carriers

Beat-to-beat blood pressure variability, hippocampal atrophy, and memory impairment in older adults

Contact Info

Product

Resources

About