The impact of hypertension on cerebral perfusion and cortical thickness in older adults

Alosco, Michael L.; Gunstad, John; Xu, Xiaomeng; Clark, Uraina S.; Labbe, Donald R.; Riskin-Jones, Hannah; Terrero, Gretel; Schwarz, Nicolette F.; Walsh, Edward G.; Poppas, Athena; Cohen, Ronald A.; Sweet, Lawrence H.

doi:10.1016/j.jash.2014.04.002

Cited by 69 publications

(59 citation statements)

References 68 publications

(64 reference statements)

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“…Virtanen et al 2003) have also been shown to be associated with negative brain structural (morphological) outcomes (e.g. Alosco et al 2014). Longitudinal studies are necessary to clarify the role of aging in the association of cortical thickness and HRV to address potential (1) top-down (i.e.…”

Section: Discussionmentioning

confidence: 99%

Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples

et al. 2017

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Previous research has shown associations between brain structure and resting state high-frequency heart rate variability (HF-HRV). Age affects both brain structure and HF-HRV. Therefore we sought to examine the relationship between brain structure and HF-HRV as a function of age. Data from two independent studies were used for the present analysis. Study 1 included 19 older adults (10 males, age range 62–78 years) and 19 younger adults (12 males, age range 19–37). Study 2 included 23 older adults (12 males; age range 55–75) and 27 younger adults (17 males; age range 18–34). The root-mean-square of successive R-R-interval differences (RMSSD) from ECG recordings was used as time-domain measure of HF-HRV. MRI scans were performed on a 3.0-T Siemens Magnetom Trio scanner. Cortical reconstruction and volumetric segmentation were performed with the Freesurfer image analysis suite, including 12 regions as regions-of-interests (ROI). Zero-order and partial correlations were used to assess the correlation of RMSSD with cortical thickness in selected ROIs. Lateral orbitofrontal cortex (OFC) cortical thickness was significantly associated with RMSSD. Further, both studies, in line with previous research, showed correlations between RMSSD and anterior cingulate cortex (ACC) cortical thickness. Meta-analysis on adjusted correlation coefficients from individual studies confirmed an association of RMSSD with the left rostral ACC and the left lateral OFC. Future longitudinal studies are necessary to trace individual trajectories in the association of HRV and brain structure across aging.

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Section: Discussionmentioning

confidence: 99%

Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples

et al. 2017

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“…Also, it might be possible that the bidirectional relationship between change in CBF and brain atrophy is not modified by the presence of cardiovascular risk factors although these cardiovascular risk factors could be determinants for reduced CBF and brain atrophy separately. 33,[43][44][45][46] Finally, the possibility of residual confounding because of an unknown confounder cannot be completely ruled out.…”

Section: Discussionmentioning

confidence: 99%

The Bidirectional Association between Reduced Cerebral Blood Flow and Brain Atrophy in the General Population

Zonneveld

Loehrer

Hofman

et al. 2015

J Cereb Blood Flow Metab

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The question remains whether reduced cerebral blood flow (CBF) leads to brain atrophy or vice versa. We studied the longitudinal relation between CBF and brain volume in a community-dwelling population. In the Rotterdam Study, 3011 participants (mean age 59.6 years (s.d. 8.0)) underwent repeat brain magnetic resonance imaging to quantify brain volume and CBF at two time points. Adjusted linear regression models were used to investigate the bidirectional relation between CBF and brain volume. We found that smaller brain volume at baseline was associated with a steeper decrease in CBF in the whole population (standardized change per s.d. increase of total brain volume (TBV) = 0.296 (95% confidence interval (CI) 0.200; 0.393)). Only in persons aged ⩾ 65 years, a lower CBF at baseline was associated with steeper decline of TBV (standardized change per s.d. increase of CBF = 0.003 (95% CI − 0.004; 0.010) in the whole population and 0.020 (95% CI 0.004; 0.036) in those aged ⩾ 65 years of age). Our results indicate that brain atrophy causes CBF to decrease over time, rather than vice versa. Only in persons aged 465 years of age did we find lower CBF to also relate to brain atrophy.

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“…A recent study in elderly subjects has demonstrated a decreased temporal and occipital brain perfusion, total and regional cortical thickness in participants with hypertension when compared to those without hypertension [44]. The negative impact of hypertension on total brain perfusion remained reduced irrespective of patients’ age.…”

Section: Introductionmentioning

confidence: 99%

“…The negative impact of hypertension on total brain perfusion remained reduced irrespective of patients’ age. Reduced total brain perfusion predicted a decrease in cortical thickness whereas antihypertensive therapy was unrelated to total cerebral perfusion or cortical thickness [44]. …”

Section: Introductionmentioning

confidence: 99%

Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden

Tadić

Cuspidi

Hering

2016

BMC Cardiovasc Disord

118

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Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer’s disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established. Cognition has improved following the use of at least one representative agent of the major drug classes with further neuroprotection with renin angiotensin inhibitors and calcium channel blockers in the hypertensive elderly. However, a reduction in BP may worsen cerebral perfusion causing an increased risk of CV complications due to the J-curve phenomenon. Given the uncertainties and conflicting results from randomized trials regarding the hypertension management in the elderly, particularly octogenarians, antihypertensive approaches are primarily based on expert opinion. Herein, we summarize available data linking arterial hypertension to cognitive decline and antihypertensive approach with potential benefits in improving cognitive function in elderly hypertensive patients.

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The impact of hypertension on cerebral perfusion and cortical thickness in older adults

Cited by 69 publications

References 68 publications

Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples

Brain structural concomitants of resting state heart rate variability in the young and old: evidence from two independent samples

The Bidirectional Association between Reduced Cerebral Blood Flow and Brain Atrophy in the General Population

Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden

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