Hayes Cellas A, Vintimilla Raul, Chaudhuri Soumilee, Odden Michelle C
Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, United States.
Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, United States.
Front Aging Neurosci. 2025 Aug 4;17:1607646. doi: 10.3389/fnagi.2025.1607646. eCollection 2025.
We aimed to determine whether cardiometabolic risk factors and blood-pressure (BP) metrics were differentially associated with white matter hyperintensities volume (WMHV) in males versus females in the Health and Aging Brain Study-Health Disparities.
We analyzed 3,585 community-dwelling adults (2,207 females) from non-Hispanic White, non-Hispanic Black, and Hispanic groups who underwent BP measurement and WMHV quantification. Linear regression models assessed (i) individual risk factors (diabetes, hypertension, dyslipidemia, obesity, tobacco dependence), (ii) a composite risk score, and (iii) four BP metrics (systolic, diastolic, pulse pressure, mean arterial pressure), each including a sex-interaction term and adjusting for age, education, race/ethnicity, and scanner. A second BP model also controlled for all five risk factors.
Diabetes (β = 0.46, 95% CI 0.28-0.64), hypertension (β = 0.47, 0.30-0.64), and higher composite risk (β = 0.19, 0.12-0.26) were associated with greater WMHV. Diastolic BP (β = 0.18, 0.11-0.26) and mean arterial pressure (β = 0.14, 0.07-0.21) related to larger WMHV, with diastolic BP remaining significant after full adjustment (β = 0.14, 0.07-0.22). No sex interactions survived correction.
These findings underscore the importance of aggressive cardiometabolic and BP control, particularly diastolic BP, to mitigate WMHV in both sexes.
在健康与衰老大脑研究-健康差异项目中，我们旨在确定男性和女性的心脏代谢危险因素及血压指标与脑白质高信号体积（WMHV）之间是否存在差异关联。
我们分析了来自非西班牙裔白人、非西班牙裔黑人及西班牙裔群体的3585名社区居住成年人（2207名女性），这些人接受了血压测量和WMHV量化。线性回归模型评估了（i）个体危险因素（糖尿病、高血压、血脂异常、肥胖、烟草依赖），（ii）综合风险评分，以及（iii）四个血压指标（收缩压、舒张压、脉压、平均动脉压），每个指标都包含性别交互项，并对年龄、教育程度、种族/族裔和扫描仪进行了调整。第二个血压模型还对所有五个危险因素进行了控制。
糖尿病（β = 0.46，95%可信区间0.28 - 0.64）、高血压（β = 0.47，0.30 - 0.64）和更高的综合风险（β = 0.19，0.12 - 0.26）与更大的WMHV相关。舒张压（β = 0.18，0.11 - 0.26）和平均动脉压（β = 0.14，0.07 - 0.21）与更大的WMHV相关，在完全调整后舒张压仍具有显著性（β = 0.14，0.07 - 0.22）。没有性别交互作用在校正后仍显著。
这些发现强调了积极控制心脏代谢和血压，特别是舒张压，以减轻两性WMHV的重要性。
