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Antihypertensive Treatment and Change in Blood Pressure Are Associated With the Progression of White Matter Lesion Volumes: The Three-City (3C)-Dijon Magnetic Resonance Imaging Study.
MedLine Citation:
PMID:  21220733     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background- Blood pressure (BP) is recognized as a major risk factor for white matter lesions (WMLs), but longitudinal data are scarce, and there is insufficient evidence for the benefit of antihypertensive therapy on WML progression. We studied the relationship between BP change and WML volume progression over time in a sample of 1319 elderly individuals who had 2 cerebral magnetic resonance imaging examinations 4 years apart. We also examined the impact of antihypertensive treatment on WML progression. Methods and Results- Subjects were participants from the Three-City (3C)-Dijon Magnetic Resonance Imaging Study, a prospective population-based cohort of elderly ≥65 years of age. WML volumes and their progression were estimated with the use of a fully automatic procedure. We performed ANCOVA models first to assess the association between BP change and WML progression and second to estimate the relation between antihypertensive treatment and WML load progression. Baseline and change in BP were significant predictors of higher WML progression over time after controlling for potential confounders. Among subjects with high SBP (≥160 mm Hg) at baseline not treated by antihypertensive medication, antihypertensive treatment started within 2 years was related to a smaller increase in WML volume at a 4-year follow-up (0.24 cm(3); SE=0.44 cm(3)) than no hypertensive treatment (1.60 cm(3); SE=0.26 cm(3); P=0.0008) on multivariable modeling. Conclusions- Our findings reinforce the hypothesis that hypertension is a strong predictor of WML and that adequate treatment may reduce the course of WML progression. Because WMLs are linked to both dementia and stroke risks, these results could have implications for future preventive trials.
Authors:
Ophélia Godin; Christophe Tzourio; Pauline Maillard; Bernard Mazoyer; Carole Dufouil
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Publication Detail:
Type:  Journal Article     Date:  2011-01-10
Journal Detail:
Title:  Circulation     Volume:  123     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  266-73     Citation Subset:  AIM; IM    
Affiliation:
INSERM Unit 708 Neuroepidemiology, Hôpital la Salpêtrière, 75651 Paris Cédex 13, France. carole.dufouil@inserm.fr.
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