Association between Blood Pressure Variability and Brain Morphology in Post-Menopausal Women Without CVD Disease

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Postmenopausal women with few modifiable cardiovascular (CV) risk factors and having greater visit-to-visit systolic blood pressure variability (BPV) have reduced hippocampal volume and increased lesion volumes at later life as compared to those with lower visit to visit BPV. These findings from a recent study strengthen the prognostic role of BPV as a prognostic indicator even amongst the elderly women who are devoid of CV risk factors.

This study aimed at elucidating the link between BPV, brain volumes, and cognitive functioning in postmenopausal women who had few modifiable CV risk factors. Postmenopausal women participating in the Women's Health Initiative Memory MRI study (WHIMS-MRI) without CVD, diabetes mellitus, hypertension, or current smoking at baseline (1996–1999) were selected for this study. BP readings were obtained at baseline and each annual follow-up visit thereafter. BPV was defined as the standard deviation (SD) associated with the mean BP across visits for each study subject. The MRI scans for brain were performed between 2004 and 2006. The Modified Mini-Mental State Examination (3MSE) scoring was used at baseline and annually thereafter (until 2008) to assess cognitive functioning.

The data of 558 women (mean age 69 years, median follow-up time 8 years) was included in the final analysis, adjusted for various confounders. Women in the highest tertile of systolic BPV had lower hippocampal volumes and higher lesion volumes as compared to their counterparts in the lowest tertile. Blood pressure variability was not associated with 3MSE scoring.

Neurology. Feb 27, 2019 (Published Online); Doi: 10.1212/WNL.0000000000007135