BP across Adulthood Linked to Late-life Brain Volume and Pathology

A UK epidemiological study revealed that high and increasing blood pressure (BP) from early adulthood into midlife seems to be associated with increased white matter hyperintensity volume (WMHV) and smaller brain volumes at 69–71 years of age. The study included 502 individuals from a cohort born throughout mainland Britain in one week in 1946, 465 participants (51% men, mean age 70·7 years, 18% amyloid-β-positive) were included in T1 and FLAIR volumetric MRI and florbetapir amyloid-PET imaging analyses. Higher systolic BP (SBP) and diastolic BP (DBP) at age 53 years and greater increases in SBP and DBP between 43 and 53 years were positively associated with WMHV at 69–71 years of age (increase in mean WMHV per 10 mm Hg greater SBP 7%; increase in mean WMHV per 10 mm Hg greater DBP 15%; increase in mean WMHV per 1 SD change in SBP or DBP 15%). Higher DBP at 43 years of age was associated with smaller whole-brain volume at 69–71 years of age (−6·9 mL per 10 mm Hg greater DBP), as were greater increases in DBP between 36 and 43 years of age (−6·5 mL per 1 SD change). Greater increases in SBP between 36 and 43 years of age were associated with smaller hippocampal volumes at 69–71 years of age (−0·03 mL per 1 SD change). Neither absolute BP nor change in BP predicted amyloid-β status or Preclinical Alzheimer Cognitive Composite score at 69–71 years of age. The findings are consistent with previous studies and suggest that BP monitoring and interventions might need to start around 40 years of age to maximize late-life brain health. It is estimated that around 30% of dementia are potentially modifiable. Source: https://www.thelancet.com/