Blood Pressure, Internal Carotid Artery Flow Parameters, and Age-Related White Matter Hyperintensities

Benjamin Aribisala, Zoe Morris, Elizabeth Eadie, Avril Thomas, Alan Gow, Maria Valdes Hernandez, Natalie Royle, Mark Bastin, John Starr, Ian Deary, Joanna Wardlaw

Research output: Contribution to journalArticlepeer-review

Abstract

White matter hyperintensities (WMH) are associated with hypertension. We examined interactions between blood pressure (BP), internal carotid artery (ICA) flow velocity parameters and WMH. We obtained BP measurements from 694 community-dwelling subjects at mean ages 69.6 (±0.8) and again at 72.6 (±0.7) years, plus brain MRI and ICA ultrasound at age 73±1 years. Diastolic and mean BP decreased and pulse pressure increased but systolic BP did not change between 70 and 73 years. Multiple linear regression, corrected for vascular disease and risk factors, showed that WMH at age 73 were associated with history of hypertension (β=0.13,p<0.001) and with BP at age 70 (systolic β=0.08, mean β=0.09, diastolic β=0.08, all p<0.05); similar but attenuated associations were seen for BP at age 73. Lower diastolic BP and higher pulse pressure were associated with higher ICA pulsatility index at age 73 (diastolic BP: standardized β, age 70= -0.24, p<0.001; pulse pressure age 70 β=0.19, p<0.001). WMH were associated with higher ICA pulsatility index (β=0.13, p=0.002) after adjusting for BP and correction for multiple testing. Therefore falling diastolic BP and increased pulse pressure are associated with increased ICA pulsatility index, which in turn is associated with WMH. This suggests that hypertension and WMH may either associate indirectly because hypertension increases arterial stiffness which leads to WMH over time, or co-associate through advancing age and stiffer vessels, or both. Reducing vascular stiffness may reduce WMH progression and should be tested in randomised trials, in addition to testing antihypertensive therapy.
Original languageEnglish
Pages (from-to)1011-1018
Number of pages8
JournalHypertension
Volume63
Issue number5
Early online date27 Jan 2014
DOIs
Publication statusPublished - 8 Feb 2014

Keywords

  • blood flow velocity
  • blood pressure
  • pulse pressure
  • white matter hyperintensities
  • ageing
  • magnetic resonance imaging
  • MRI

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