Document Detail


Baseline and longitudinal increases in diastolic blood pressure are associated with greater white matter hyperintensity volume: the northern Manhattan study.
MedLine Citation:
PMID:  21836088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Elevated blood pressure (BP) is a risk factor for stroke and dementia, but the effect of BP, and change in BP over time, on white matter hyperintensity volume (WMHV) is not fully understood. Few studies have included Hispanics, who are at greater risk of stroke and dementia than non-Hispanic whites. We examined BP in relation to WMHV in a stroke-free cohort.
METHODS: The Northern Manhattan Study includes 1290 stroke-free participants who had brain MRI. We examined baseline systolic and diastolic (DBP) BP, and changes in BP from baseline to MRI, and WMHV.
RESULTS: There were 1281 participants with brain MRI and 2 BP measurements (mean age, 64 years; SD=8; range, 40 to 94 years). Baseline DBP was associated with greater WMHV (P<0.0001) independent of sociodemographic and vascular risk factors. Each 10 mm Hg above the mean baseline DBP (83±11 mm Hg) was associated with a 1.17% greater WMHV. Over 7 years average follow-up, participants with an increase >5 mm Hg DBP from baseline to MRI had 1.21% greater WMHV relative to those whose BP did not increase (P=0.02). The association between baseline DBP and WMHV was strongest for blacks compared with Hispanics and whites (interaction P=0.04).
CONCLUSIONS: Baseline DBP and longitudinal increases in DBP were independently associated with a greater WMHV, and the association between DBP and WMHV was greatest among blacks.
Authors:
Justin Marcus; Hannah Gardener; Tatjana Rundek; Mitchell S V Elkind; Ralph L Sacco; Charles Decarli; Clinton B Wright
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2011-08-11
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-30     Completed Date:  2011-10-24     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2639-41     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans
Aged
Aged, 80 and over
Blood Pressure*
Cerebellum / physiopathology*,  radiography*
Dementia, Vascular / etiology,  physiopathology,  radiography
European Continental Ancestry Group
Female
Follow-Up Studies
Hispanic Americans
Humans
Magnetic Resonance Imaging*
Male
Stroke / ethnology,  etiology,  physiopathology,  radiography
Grant Support
ID/Acronym/Agency:
K02 NS059729/NS/NINDS NIH HHS; K02 NS059729/NS/NINDS NIH HHS; K02 NS059729-04/NS/NINDS NIH HHS; R37 NS029993/NS/NINDS NIH HHS; R37 NS029993-20/NS/NINDS NIH HHS; R37 NS29993/NS/NINDS NIH HHS
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