Abstract
Long-standing hypertension has been associated with global and regional brain atrophy. Little is known regarding the timing of atrophy onset and its relationship with duration and severity of hypertension. A systematic literature review was performed to identify the relationships between hypertension and brain atrophy measured using neuroimaging, to summarize the existing knowledge and to identify areas for future investigation. Most studies identified that higher systolic blood pressure was associated with late-life brain atrophy; however, these studies did not include a concurrent assessment of brain imaging in mid-life, and participants in these studies were middle-aged in the 1980s when definitions of blood pressure (BP) were more permissive and population BP control was poorer. To investigate the relationship between BP and brain atrophy in mid-life in a contemporary cohort, brain magnetic resonance (MR) images were analyzed in 778 individuals participating in the population-based PURE-MIND study, a sub-study of the international Prospective Urban Rural Epidemiologic (PURE) Study designed to identify the risk factors for common non-communicable diseases. MR data were processed for global and regional brain volumes and cortical thickness. No significant association was seen between brain volume and hypertension, after controlling for age and gender. However, few participants had markedly elevated BP, probably due to improving population-wide control of hypertension due to lower thresholds for successful treatment than in past decades. Analysis showed that brain atrophy is not a common consequence of mid-life hypertension in today’s Canadians. It is possible that aggressive screening and control of mid-life BP might prevent atrophic changes.
Grantingagency
NSERC
Refereed
Yes
