Document Detail


Blood pressure and white-matter disease progression in a biethnic cohort: Atherosclerosis Risk in Communities (ARIC) study.
MedLine Citation:
PMID:  19926835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages.
METHODS: Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared.
RESULTS: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm(3), P<0.0001) and whites (2.6 cm(3), P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95% CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only.
CONCLUSIONS: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.
Authors:
Rebecca F Gottesman; Josef Coresh; Diane J Catellier; A Richey Sharrett; Kathryn M Rose; Laura H Coker; Dean K Shibata; David S Knopman; Clifford R Jack; Thomas H Mosley
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2009-11-19
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-29     Completed Date:  2010-01-28     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group / ethnology*
Aged
Atherosclerosis / ethnology*,  pathology
Blood Pressure* / physiology
Cohort Studies
Disease Progression
Ethnic Groups
European Continental Ancestry Group / ethnology*
Female
Humans
Hypertension / ethnology,  pathology
Leukoaraiosis / ethnology*,  pathology
Magnetic Resonance Imaging
Male
Nerve Fibers, Myelinated / pathology*
Prospective Studies
Residence Characteristics*
Risk Factors
Grant Support
ID/Acronym/Agency:
N01 HC055015/HC/NHLBI NIH HHS; N01 HC055016/HC/NHLBI NIH HHS; N01 HC055018/HC/NHLBI NIH HHS; N01 HC055019/HC/NHLBI NIH HHS; N01 HC055020/HC/NHLBI NIH HHS; N01 HC055021/HC/NHLBI NIH HHS; N01 HC055022/HC/NHLBI NIH HHS; N01-HC-55015/HC/NHLBI NIH HHS; N01-HC-55016/HC/NHLBI NIH HHS; N01-HC-55018/HC/NHLBI NIH HHS; N01-HC-55019/HC/NHLBI NIH HHS; N01-HC-55020/HC/NHLBI NIH HHS; N01-HC-55021/HC/NHLBI NIH HHS; N01-HC-55022/HC/NHLBI NIH HHS; R01 HL070825/HL/NHLBI NIH HHS; R01 HL070825-01/HL/NHLBI NIH HHS; R01 HL070825-03/HL/NHLBI NIH HHS; R01-HL70825/HL/NHLBI NIH HHS; U01 HL096812/HL/NHLBI NIH HHS
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