Lifetime hypertension as a predictor of brain structure in older adults: Cohort study with a 28-year follow-up

Charlotte L. Allan, Enikõ Zsoldos, Nicola Filippini, Claire E. Sexton, Anya Topiwala, Vyara Valkanova, Archana Singh-Manoux, Adam G. Tabák, Martin J. Shipley, Clare Mackay, Klaus P. Ebmeier, Mika Kivimäki

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22 Citations (Scopus)

Abstract

Background: Hypertension is associated with an increased risk of dementia and depression with uncertain longitudinal associations with brain structure. Aims: To examine lifetime blood pressure as a predictor of brain structure in old age. Method: A total of 190 participants (mean age 69.3 years) from the Whitehall II study were screened for hypertension six times (1985-2013). In 2012-2013, participants had a 3T-magnetic resonance imaging (MRI) brain scan. Data from the MRI were analysed using automated and visual measures of global atrophy, hippocampal atrophy and white matter hyperintensities. Results: Longitudinally, higher mean arterial pressure predicted increased automated white matter hyperintensities (P<0.002). Cross-sectionally, hypertensive participants had increased automated white matter hyperintensities and visually rated deep white matter hyperintensities. There was no significant association with global or hippocampal atrophy. Conclusions: Long-term exposure to high blood pressure predicts hyperintensities, particularly in deep white matter. The greatest changes are seen in those with severe forms of hypertension, suggesting a dose-response pattern.

Original languageEnglish
Pages (from-to)308-315
Number of pages8
JournalBritish Journal of Psychiatry
Volume206
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

ASJC Scopus subject areas

  • Psychiatry and Mental health

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    Allan, C. L., Zsoldos, E., Filippini, N., Sexton, C. E., Topiwala, A., Valkanova, V., Singh-Manoux, A., Tabák, A. G., Shipley, M. J., Mackay, C., Ebmeier, K. P., & Kivimäki, M. (2015). Lifetime hypertension as a predictor of brain structure in older adults: Cohort study with a 28-year follow-up. British Journal of Psychiatry, 206(4), 308-315. https://doi.org/10.1192/bjp.bp.114.153536