TY - JOUR
T1 - Inter-relations of orthostatic blood pressure change, aortic stiffness, and brain structure and function in young adults
AU - Cooper, Leroy L.
AU - Himali, Jayandra J.
AU - Torjesen, Alyssa
AU - Tsao, Connie W.
AU - Beiser, Alexa
AU - Hamburg, Naomi M.
AU - DeCarli, Charles
AU - Vasan, Ramachandran S.
AU - Seshadri, Sudha
AU - Pase, Matthew P.
AU - Mitchell, Gary F.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Background--Relations of orthostatic change in blood pressure with brain structure and function have not been studied thoroughly, particularly in younger, healthier individuals. Elucidation of factors that contribute to early changes in brain integrity may lead to development of interventions that delay or prevent cognitive impairment. Methods and Results--In a sample of the Framingham Heart Study Third Generation (N=2119; 53% women; mean age±SD, 47±8 years), we assessed orthostatic change in mean arterial pressure (MAP), aortic stiffness (carotid-femoral pulse wave velocity), neuropsychological function, and markers of subclinical brain injury on magnetic resonance imaging. Multivariable regression analyses were used to assess relations between orthostatic change in MAP and brain structural and neuropsychological outcomes. Greater orthostatic increase in MAP on standing was related to better Trails B-A performance among participants aged < 49 years (β±SE, 0.062±0.029; P=0.031) and among participants with carotid-femoral pulse wave velocity < 6.9 m/s (β±SE, 0.063±0.026; P=0.016). This relation was not significant among participants who were older or had stiffer aortas. Conversely, greater orthostatic increase in MAP was related to larger total brain volume among older participants (β±SE, 0.065±0.029; P=0.023) and among participants with carotid-femoral pulse wave velocity ≥6.9 m/s (β±SE, 0.078±0.031; P=0.011). Conclusions--Blunted orthostatic increase in MAP was associated with smaller brain volume among participants who were older or had stiffer aortas and with poorer executive function among persons who were younger or who had more-elastic aortas. Our findings suggest that the brain is sensitive to orthostatic change in MAP, with results dependent on age and aortic stiffness.
AB - Background--Relations of orthostatic change in blood pressure with brain structure and function have not been studied thoroughly, particularly in younger, healthier individuals. Elucidation of factors that contribute to early changes in brain integrity may lead to development of interventions that delay or prevent cognitive impairment. Methods and Results--In a sample of the Framingham Heart Study Third Generation (N=2119; 53% women; mean age±SD, 47±8 years), we assessed orthostatic change in mean arterial pressure (MAP), aortic stiffness (carotid-femoral pulse wave velocity), neuropsychological function, and markers of subclinical brain injury on magnetic resonance imaging. Multivariable regression analyses were used to assess relations between orthostatic change in MAP and brain structural and neuropsychological outcomes. Greater orthostatic increase in MAP on standing was related to better Trails B-A performance among participants aged < 49 years (β±SE, 0.062±0.029; P=0.031) and among participants with carotid-femoral pulse wave velocity < 6.9 m/s (β±SE, 0.063±0.026; P=0.016). This relation was not significant among participants who were older or had stiffer aortas. Conversely, greater orthostatic increase in MAP was related to larger total brain volume among older participants (β±SE, 0.065±0.029; P=0.023) and among participants with carotid-femoral pulse wave velocity ≥6.9 m/s (β±SE, 0.078±0.031; P=0.011). Conclusions--Blunted orthostatic increase in MAP was associated with smaller brain volume among participants who were older or had stiffer aortas and with poorer executive function among persons who were younger or who had more-elastic aortas. Our findings suggest that the brain is sensitive to orthostatic change in MAP, with results dependent on age and aortic stiffness.
KW - Aging
KW - Aortic stiffness
KW - Cognitive impairment
KW - Magnetic resonance imaging
KW - Orthostatic hypotension
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U2 - 10.1161/JAHA.117.006206
DO - 10.1161/JAHA.117.006206
M3 - Article
C2 - 28862943
AN - SCOPUS:85030699788
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 8
M1 - e006206
ER -