Allan Charlotte L, Zsoldos Enikõ, Filippini Nicola, Sexton Claire E, Topiwala Anya, Valkanova Vyara, Singh-Manoux Archana, Tabák Adam G, Shipley Martin J, Mackay Clare, Ebmeier Klaus P, Kivimäki Mika
Charlotte L. Allan, MRCPsych, MD(Res), Enikõ Zsoldos, MSc, Nicola Filippini, DPhil, Claire E. Sexton, DPhil, Anya Topiwala, MRCPsych, Vyara Valkanova, MD, Neurobiology of Ageing Group, Department of Psychiatry, University of Oxford, Oxford, UK; Archana Singh-Manoux, PhD, Department of Epidemiology and Public Health, University College London, London, UK and INSERM U1018, Hôpital Paul Brousse, France; Adam G. Tabák, MD, PhD, Department of Epidemiology and Public Health, University College London, London, UK and 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary; Martin J. Shipley, MSc, Department of Epidemiology and Public Health, University College London, London, UK; Clare Mackay, PhD, Klaus P. Ebmeier, FRCPsych, MD, Neurobiology of Ageing Group, Department of Psychiatry, University of Oxford, Oxford, UK; Mika Kivimäki, PhD, Department of Epidemiology and Public Health, University College London, London, UK.
Br J Psychiatry. 2015 Apr;206(4):308-15. doi: 10.1192/bjp.bp.114.153536. Epub 2014 Dec 11.
Hypertension is associated with an increased risk of dementia and depression with uncertain longitudinal associations with brain structure.
To examine lifetime blood pressure as a predictor of brain structure in old age.
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.
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.
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.
高血压与痴呆和抑郁风险增加相关，其与脑结构的纵向关联尚不确定。
研究终生血压作为老年脑结构预测指标的情况。
对来自白厅II研究的190名参与者（平均年龄69.3岁）在1985年至2013年期间进行了6次高血压筛查。在2012年至2013年，参与者接受了3T磁共振成像（MRI）脑部扫描。使用全脑萎缩、海马萎缩和白质高信号的自动测量和视觉测量方法对MRI数据进行分析。
纵向来看，较高的平均动脉压预示着自动测量的白质高信号增加（P<0.002）。横断面分析显示，高血压参与者自动测量的白质高信号增加，且视觉评估的深部白质高信号也增加。与全脑或海马萎缩无显著关联。
长期暴露于高血压会导致白质高信号，尤其是深部白质。在严重高血压患者中可见最大变化，提示存在剂量反应模式。
