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This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 64, Number 11, June 14, 2005 All Versions of this Article: 01.WNL.0000164712.24389.BBv1 64/11/1846    most recent Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Goldstein, I. B. Articles by Shapiro, D. Search for Related Content PubMed PubMed Citation Articles by Goldstein, I. B. Articles by Shapiro, D. Related Collections MRI Volumetric MRI All Neuropsychology/Behavior Cognitive aging MCI (mild cognitive impairment) Risk factors in epidemiology

Ambulatory blood pressure and the brain

A 5-year follow-up

From the Departments of Psychiatry and Biobehavioral Sciences and Neurology, University of California, Los Angeles.

Address correspondence and reprint requests to Dr. Iris B. Goldstein, UCLA Department of Psychiatry, 760 Westwood Plaza, Los Angeles, CA 90095-1759; e-mail: irisg{at}ucla.edu

Objective: To determine if initial values of casual and ambulatory systolic blood pressure (SBP) predict white matter hyperintensities, insular subcortex hyperintensities, and brain atrophy 5 years later in a group of healthy elderly individuals.

Methods: The authors studied 155 healthy men and women, aged 55 to 79 years. Two 24-hour ambulatory blood pressure (BP) sessions assessed BP level and variability during waking and sleep. Hyperintensities and total brain volume were quantified by MRI. Procedures were repeated 5 years later in 78% (121) of subjects.

Results: Hyperintensities and brain atrophy increased over time, with greater increases among older subjects. The presence of increased BP level and variability initially and again 5 years later had negative consequences for the brain. Independent of age, the greater the initial SBP, the greater the likelihood that individuals would have severe white matter hyperintensities after 5 years. Also, elevated casual SBP was associated with severe insular subcortex hyperintensities and greater SBP sleep variability with increased brain atrophy.

Conclusions: Among healthy elderly individuals whose initial, average, casual blood pressure (BP) was relatively low (116.9/71.1 mm Hg), small increases in casual and 24-hour ambulatory BP measures were associated with greater brain atrophy and subcortical lesions after 5 years.

Editorial, see page 1832

Supported by Research Grant AG-11595 from the National Institute of Aging.

Received May 28, 2004. Accepted in final form March 15, 2005.

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