Association of blood pressure with brain perfusion and structure: A population-based prospective study

Purpose: To explore the association of blood pressure (BP) measurements with cerebral blood flow (CBF) and brain structure in general population.Method: This prospective study included 902 participants from Kailuan community. All participants underwent brain MRI and BP measurements. The association of BP indicators with CBF, brain tissue volume and white matter hyperintensity (WMH) volume were investigated. In addition, mediation analysis was used to determine whether significantly changed brain tissue volume explained associations between BP and CBF.Results: Elevated diastolic BP (DBP), but not systolic BP (SBP), was associated with lower CBF in the total brain (& beta; [95 % CI]: -0.62 [-1.14, - 0.10]), total gray matter (& beta; [95 % CI]: -0.71 [-1.27, - 0.14]), hippocampus (& beta; [95 % CI]: -0.59 [-1.13, -0.05]), frontal (& beta; [95 % CI]: -0.72 [-1.31, -0.13]), parietal (& beta; [95 % CI]: -0.92 [-1.54, -0.3]), temporal (& beta; [95 % CI]: -0.63 [-1.18, -0.08]), and occipital lobe (& beta; [95 % CI]: -0.69 [-1.37, -0.01]). Higher SBP and DBP were associated with reduced total and regional brain tissue volume (all p < 0.05). Increased SBP and PP were associated with higher total and periventricular WMH volume (all p < 0.05). In addition, mediation analysis identified that significantly decreased brain volume did not mediate the associations of BP measurements and lower CBF in corresponding region (all p > 0.05).Conclusions: Elevated BP level was associated with decreased total and regional CBF and brain tissue volume and increased WMH burden.

Automated summary

This study aimed to investigate the association between blood pressure measurements and cerebral blood flow (CBF) and brain structure in the general population. The results showed that elevated diastolic blood pressure (DBP) was associated with lower CBF and reduced brain tissue volume, while higher systolic blood pressure (SBP) and DBP were associated with increased white matter hyperintensity (WMH) volume. Mediation analysis indicated that decreased brain volume did not mediate the associations between blood pressure and lower CBF.