The impact of hypertension on cerebral perfusion and cortical thickness in older adults.
The impact of hypertension on cerebral perfusion and cortical thickness in older adults.
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DOI：
10.1016/j.jash.2014.04.002
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发表时间：
2014-08
期刊：
影响因子：
--
通讯作者：
Sweet LH
中科院分区：
文献类型：
--
作者：
Alosco ML;Gunstad J;Xu X;Clark US;Labbe DR;Riskin-Jones HH;Terrero G;Schwarz NF;Walsh EG;Poppas A;Cohen RA;Sweet LH
高血压可能会增加患痴呆症的风险，可能是因为它与皮质厚度减少有关。大脑自动调节紊乱是高血压影响大脑结构的一种可能机制，但人们对高血压、大脑灌注和皮质厚度之间的关系知之甚少。当前样本由 58 名患有不同程度血管疾病的老年人组成。高血压的诊断史和抗高血压药物状态是通过自我报告确定的，如果有的话，通过病历审查进行确认。所有参与者均接受了动脉自旋标记和 T1 加权磁共振成像 (MRI)，以量化总和局部皮质灌注和厚度。对医学变量调整的协方差分析表明，与没有高血压的参与者相比，患有高血压的参与者表现出颞叶和枕叶脑灌注以及总和区域皮质厚度减少。即使在调整年龄后，高血压对总脑灌注的影响仍然没有变化，但皮质厚度没有出现这种模式。总脑灌注减少预示着全脑以及额叶、颞叶和顶叶皮质厚度的减少。抗高血压治疗与总脑灌注或皮质厚度无关。这项研究为高血压诊断史对大脑灌注不足和皮质厚度减少的不利影响提供了初步证据。需要进行纵向研究来调查高血压的作用及其与其他影响因素（例如年龄）的相互作用在脑灌注不足和皮质厚度减少的表现中。
Hypertension may increase risk for dementia possibly because of its association with decreased cortical thickness. Disturbed cerebral autoregulation is one plausible mechanism by which hypertension impacts the cerebral structure, but the associations among hypertension, brain perfusion, and cortical thickness are poorly understood. The current sample consisted of 58 older adults with varying levels of vascular disease. Diagnostic history of hypertension and antihypertensive medication status was ascertained through self-report and, when available, confirmed by medical record review. All participants underwent arterial spin labeling and T1-weighted magnetic resonance imaging (MRI) to quantify total and regional cortical perfusion and thickness. Analysis of covariance adjusting for medical variables showed that participants with hypertension exhibited reduced temporal and occipital brain perfusion as well as total and regional cortical thickness relative to those without hypertension. The effects of hypertension on total brain perfusion remained unchanged even after adjustment for age, though no such pattern emerged for cortical thickness. Decreased total brain perfusion predicted reduced thickness of the total brain as well as of the frontal, temporal, and parietal lobe cortices. Antihypertensive treatment was not associated with total cerebral perfusion or cortical thickness. This study provides initial evidence for the adverse effects of a diagnostic history of hypertension on brain hypoperfusion and reduced cortical thickness. Longitudinal studies are needed to investigate the role of hypertension and its interaction with other contributing factors (e.g., age) in the manifestation of cerebral hypoperfusion and reduced cortical thickness.
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