Blood pressure and white-matter disease progression in a biethnic cohort: Atherosclerosis risk in communities (ARIC) study

Rebecca F. Gottesman, Josef Coresh, Diane J. Catellier, A. Richey Sharrett, Kathryn M. Rose, Laura H. Coker, Dean K. Shibata, David S Knopman, Clifford R Jr. Jack, Thomas H. Mosley

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE-: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. METHODS-: Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. RESULTS-: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm, P<0.0001) and whites (2.6 cm, P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95% CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only. CONCLUSIONS-: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.

Original languageEnglish (US)
Pages (from-to)3-8
Number of pages6
JournalStroke
Volume41
Issue number1
DOIs
StatePublished - Jan 2010

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Leukoencephalopathies
Disease Progression
Atherosclerosis
Blood Pressure
White Matter
Longitudinal Studies
Odds Ratio
Magnetic Resonance Imaging

Keywords

  • Epidemiology
  • Hypertension
  • Leukoaraiosis
  • MRI

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Gottesman, R. F., Coresh, J., Catellier, D. J., Sharrett, A. R., Rose, K. M., Coker, L. H., ... Mosley, T. H. (2010). Blood pressure and white-matter disease progression in a biethnic cohort: Atherosclerosis risk in communities (ARIC) study. Stroke, 41(1), 3-8. https://doi.org/10.1161/STROKEAHA.109.566992

Blood pressure and white-matter disease progression in a biethnic cohort : Atherosclerosis risk in communities (ARIC) study. / Gottesman, Rebecca F.; Coresh, Josef; Catellier, Diane J.; Sharrett, A. Richey; Rose, Kathryn M.; Coker, Laura H.; Shibata, Dean K.; Knopman, David S; Jack, Clifford R Jr.; Mosley, Thomas H.

In: Stroke, Vol. 41, No. 1, 01.2010, p. 3-8.

Research output: Contribution to journalArticle

Gottesman, RF, Coresh, J, Catellier, DJ, Sharrett, AR, Rose, KM, Coker, LH, Shibata, DK, Knopman, DS, Jack, CRJ & Mosley, TH 2010, 'Blood pressure and white-matter disease progression in a biethnic cohort: Atherosclerosis risk in communities (ARIC) study', Stroke, vol. 41, no. 1, pp. 3-8. https://doi.org/10.1161/STROKEAHA.109.566992
Gottesman, Rebecca F. ; Coresh, Josef ; Catellier, Diane J. ; Sharrett, A. Richey ; Rose, Kathryn M. ; Coker, Laura H. ; Shibata, Dean K. ; Knopman, David S ; Jack, Clifford R Jr. ; Mosley, Thomas H. / Blood pressure and white-matter disease progression in a biethnic cohort : Atherosclerosis risk in communities (ARIC) study. In: Stroke. 2010 ; Vol. 41, No. 1. pp. 3-8.
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abstract = "BACKGROUND AND PURPOSE-: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. METHODS-: Participants were 983 individuals (49{\%} black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. RESULTS-: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm, P<0.0001) and whites (2.6 cm, P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95{\%} CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only. CONCLUSIONS-: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.",
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T2 - Atherosclerosis risk in communities (ARIC) study

AU - Gottesman, Rebecca F.

AU - Coresh, Josef

AU - Catellier, Diane J.

AU - Sharrett, A. Richey

AU - Rose, Kathryn M.

AU - Coker, Laura H.

AU - Shibata, Dean K.

AU - Knopman, David S

AU - Jack, Clifford R Jr.

AU - Mosley, Thomas H.

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N2 - BACKGROUND AND PURPOSE-: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. METHODS-: Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. RESULTS-: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm, P<0.0001) and whites (2.6 cm, P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95% CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only. CONCLUSIONS-: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.

AB - BACKGROUND AND PURPOSE-: Blood pressure (BP) is a predictor of concurrent and subsequently measured white-matter hyperintensity (WMH), but longitudinal studies of WMH changes and data in black participants are lacking. We hypothesized that WMH progression would be (1) strongly related to BP in blacks and whites and (2) predicted more strongly by earlier (midlife) or cumulative BP measurements than by measures at older ages. METHODS-: Participants were 983 individuals (49% black) from the Atherosclerosis Risk in Communities (ARIC) Study who underwent cerebral magnetic resonance imaging in 1993-1995 and 2004-2006. Associations between BP (measured at each of 5 visits, in addition to a time-averaged cumulative BP) and progression of WMHs were analyzed and compared. RESULTS-: Cumulative systolic BP (SBP) was the strongest BP predictor of WMH progression in adjusted models. Higher cumulative SBP (by 20 mm Hg) was associated with greater progression of WMHs and was similar in blacks (2.5 cm, P<0.0001) and whites (2.6 cm, P<0.0001). Higher cumulative SBP (per 20 mm Hg) was also associated with being in the top quintile of WMH progression (adjusted odds ratio=2.0; 95% CI, 1.6 to 2.6). Earlier SBP measurements were stronger predictors of WMH progression than were later SBP measurements, but in blacks only. CONCLUSIONS-: In this population-based cohort, cumulative SBP was a stronger predictor of WMH progression than SBP from individual visits, in both blacks and whites. Earlier BPs were stronger predictors than BPs measured at later time points in blacks only.

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KW - Hypertension

KW - Leukoaraiosis

KW - MRI

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