University of California, San Francisco, San Francisco, California, USA.
University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Alzheimers Dement. 2023 Mar;19(3):924-932. doi: 10.1002/alz.12725. Epub 2022 Jul 2.
High blood pressure (BP) is a risk factor for late-life brain health; however, the association of elevated BP with brain health in mid-life is unclear.
We identified 661 participants from the Coronary Artery Risk Development in Young Adults Study (age 18-30 at baseline) with 30 years of follow-up and brain magnetic resonance imaging at year 30. Cumulative exposure of BP was estimated by time-weighted averages (TWA). Ideal cardiovascular health was defined as systolic BP < 120 mm Hg, diastolic BP < 80 mm Hg. Brain age was calculated using previously validated high dimensional machine learning pattern analyses.
Every 5 mmHg increment in TWA systolic BP was associated with approximately 1-year greater brain age (95% confidence interval [CI]: 0.50-1.36) Participants with TWA systolic or diastolic BP over the recommended guidelines for ideal cardiovascular health, had on average 3-year greater brain age (95% CI: 1.00-4.67; 95% CI: 1.45-5.13, respectively).
Elevated BP from early to mid adulthood, even below clinical cut-offs, is associated with advanced brain aging in mid-life.
高血压（BP）是晚年大脑健康的一个风险因素；然而，血压升高与中年大脑健康的关系尚不清楚。
我们从冠状动脉风险发展在年轻人研究（基线时年龄 18-30 岁）中确定了 661 名参与者，随访 30 年，并在第 30 年进行了脑磁共振成像。通过时间加权平均值（TWA）估计血压的累积暴露量。理想心血管健康定义为收缩压<120mmHg，舒张压<80mmHg。使用先前验证的高维机器学习模式分析计算脑龄。
TWA 收缩压每增加 5mmHg，脑龄大约增加 1 岁（95%置信区间 [CI]：0.50-1.36）。TWA 收缩压或舒张压超过理想心血管健康推荐指南的参与者，平均脑龄增加 3 岁（95% CI：1.00-4.67；95% CI：1.45-5.13）。
从中年到中年早期的血压升高，即使低于临床临界值，也与中年时的大脑老化加速有关。
