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• W2897778435 abstract "Midlife hypertension confers risk for late-life cognitive impairment, but the relationship between blood pressure (BP) and the pathologies associated with dementia – notably those of Alzheimer's disease (AD) and cerebrovascular disease – is poorly understood. We sought to investigate the relationship between midlife BP and: white matter hyperintensity volume (WMHV); β-amyloid load (Aβ); and whole brain (WBV) and hippocampal volumes (HV) at 70 years. Participants were from Insight 46, a sub-study of the MRC National Survey of Health and Development 1946 British birth cohort, and were all born in the same week of that year. BP was measured at ages 36, 43, 53, 60-64, 68 and 70yrs allowing calculation of rates of change in systolic (SBP) and diastolic BP (DBP). 238 participants with multi-modal (T1/T2/FLAIR) MRI at 1.1mm isotropic resolution and florbetapir amyloid-PET imaging were included in this interim analysis. An automated algorithm based on a multivariate Gaussian mixture model was used to quantify WMHV from multi-modal MRI. Aβ-positivity/negativity was defined at a grey matter:cerebellar SUVR cut-off of 1.078. WBV and HV were automatically segmented from T1-MRI. Statistical models, adjusted for appropriate confounders including hypertension treatment, investigated associations between BP (SBP or DBP) at each age and change in BP between 36-43, 43-53, 53-60/64 and 60/64-68 years, in separate models, and: WMHV, using a generalised linear model with gamma distribution and log link; Aβ status, using logistic regression; and brain volumes, using linear regression. Demographics are summarised in the table. Higher DBP at 53yrs (exponentiated coefficient 1.22[95% CI:1.04,1.42];p=0.01) and greater increase in DBP between 43-53yrs (1.23[1.03,1.48];p=0.03) were associated with higher WMHV. Higher SBP at 53yrs was associated with smaller WBV (β-coefficient -3.33[-6.68,0.011];p=0.05). Higher SBP at 36yrs (-0.030[-0.055,-0.0045];p=0.02) and greater increase in SBP between 36-43yrs (-0.030[-0.055,-0.0045];p=0.03) were associated with smaller HV. Greater DBP decline between 53 and 60/64yrs was associated with smaller HV (0.037[0.0031,0.071];p=0.03). BP or BP change at any time-point was not related to Aβ. Increasing BP in mid-life is associated with higher later-life WMHV and smaller brain volumes, although latterly, decreasing BP may be more critical to later-life brain volumes. Any relationship between BP and AD may not be driven by Aβ deposition." @default.
• W2897778435 created "2018-10-26" @default.
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• W2897778435 date "2018-07-01" @default.
• W2897778435 modified "2023-10-16" @default.
• W2897778435 title "O2‐05‐01: INFLUENCES OF BLOOD PRESSURE AND BLOOD PRESSURE TRAJECTORIES ON CEREBRAL PATHOLOGY AT AGE 70: RESULTS FROM A BRITISH BIRTH COHORT" @default.
• W2897778435 doi "https://doi.org/10.1016/j.jalz.2018.06.2663" @default.
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