Journal of Evidence-based Medicine

Higher blood pressure is linked to larger brain structures

In an analysis of 1,012 participants, higher blood pressure was linked to larger deep brain volumes compared with blood pressure below 120/80 millimetres of mercury.

Brain sections show enlarged deep structures beside a smaller grey comparison, with branching vessels and thick- and thin-walled arteries below.
Cohort study of 1,012 peopleMechanisms

Multicentre

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Researchers analysed 1,012 participants from a multicentre cohort study in China to evaluate how blood pressure relates to the volume of deep brain structures. Compared with people whose blood pressure was below 120/80 millimetres of mercury, participants with higher readings had larger volumes of subcortical gray matter, including the caudate, putamen, and pallidum. In a separate Mendelian randomisation analysis using genetic data, genetically predicted hypertension was also linked to larger volumes in these same brain regions. A further analysis indicated that this relationship was mediated by enlarged perivascular spaces in the basal ganglia, which are fluid-filled channels that reflect impaired waste clearance in the brain.

Why it matters

Blood pressure and brain structure often alter as people age. Clarifying how elevated blood pressure relates to subcortical gray matter may help researchers understand the mechanisms linking cardiovascular function to brain health.

Caveats

The observational findings cannot show that high blood pressure caused the brain differences, and the cohort was limited to participants in China. Genetic analyses reflect lifelong predispositions, which may not capture the effects of blood pressure changes or treatments later in life.

From the paper

Participants

A total of 1012 participants aged 29–83 years were eligible for this study.

Results, 3.1 Characteristics of the Study Population

Result

… elevated BP was associated with larger caudate volumes (SBP/DBP 130/80–140/90 mmHg: β = 0.19, 95% (CI 0.01 to 0.37, p for trend = 0.032), putamen volumes (SBP/DBP 130/80–140/90 mmHg: β = 0.27, 95% CI 0.08 to 0.46; SBP/DBP ≥ 140/90 mmHg: β = 0.31, 95% CI 0.13 to 0.49; p for trend < 0.001 …

Results, 3.2 Association Between Elevated BP and Subcortical Gray Matter Volumes

Limitation

First, the GWAS summary-level data used for MR analysis only reflects genetic susceptibility to hypertension, which cannot reflect and quantify the long-term cumulative BP burden during follow-up.

4 Discussion

Quoted word for word from the full text on onlinelibrary.wiley.com.