Document Detail

Posterior paralimbic and frontal metabolite impairments in asymptomatic hypertension with different treatment outcomes.
MedLine Citation:
PMID:  19876064     Owner:  NLM     Status:  MEDLINE    
Hypertension is associated with cognitive decline in elderly persons. We studied asymptomatic hypertensive subjects using brain magnetic resonance (MR) spectroscopy to evaluate metabolite impairments before the appearance of symptoms in patients with different treatment outcomes. In all, 14 healthy controls and 37 asymptomatic hypertensive patients (17 controlled and 20 resistant) underwent brain structural MR and MR spectroscopy of the posterior paralimbic (PPL) area and left frontal white matter. Ischemic burden (IB), global cortical atrophy and microbleeds were analyzed with visual scales. Metabolite ratios involving N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho) and myoinositol (mI) were computed. Ultrasound measurements, including intima-media thickness, plaques and hemodynamic ratios, were obtained. Intergroup differences in IB, atrophy and metabolite ratios, and the atrophy and IB relationship were assessed with parametric and nonparametric statistical tests. In addition, the impacts of demographic, analytic and clinical factors, ischemia and atrophy, and ultrasound measurements on metabolite ratios were assessed. The significance level was set at P<or=0.05. Higher atrophy scores presented with higher total or frontal IB (P<0.05). However, there was no intergroup difference in atrophy and IB. PPL mI/Cr was increased in resistant hypertension (P<0.021), whereas frontal NAA/Cr (P<0.007) showed opposite trends between controlled (increased ratios) and resistant (decreased ratios) hypertension. Unlike PPL mI/Cr, frontal NAA/Cr showed significant correlations with the lipid profile and ultrasound measurements. PPL mI/Cr increases in resistant hypertension, and frontal NAA/Cr diverges between controlled and resistant hypertension before physical and neuropsychological symptoms appear.
Jos? M Garc?a Santos; Luis J Fuentes; Juan B Vidal; Andr?s Carrillo; Martirio Antequera; Guillermo Campoy; Carmen Ant?nez; Silvia Torres del R?o; Julia Garc?a-Sevilla; Gin?s Ortega
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-30
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  33     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-05     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  67-75     Citation Subset:  IM    
Neuroradiology Section, Department of Diagnostic Radiology, Hospital General Universitario Morales Meseguer, Murcia, Spain.
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MeSH Terms
Antihypertensive Agents / therapeutic use
Aspartic Acid / analogs & derivatives,  metabolism
Brain / pathology
Brain Chemistry / drug effects,  physiology
Cerebral Hemorrhage / complications,  epidemiology
Creatine / metabolism
Data Interpretation, Statistical
Frontal Lobe / chemistry,  metabolism*
Hypertension / drug therapy*,  metabolism*,  ultrasonography
Limbic System / chemistry,  metabolism*
Magnetic Resonance Spectroscopy
Middle Aged
Reproducibility of Results
Treatment Outcome
Reg. No./Substance:
0/Antihypertensive Agents; 56-84-8/Aspartic Acid; 57-00-1/Creatine; 997-55-7/N-acetylaspartate

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