Influence of preeclampsia and late-life hypertension on MRI measures of cortical atrophy

Objective:Women with a history of preeclampsia are at an increased risk of hypertension and structural brain changes. However, the combined effect of both preeclampsia and late-life hypertension on brain structural changes is not known and was investigated in this study.Methods:Participants were identified from the population-based Rochester Epidemiology Project cohort. Four groups of women were recruited and investigated in this study: first, women with a history of normotensive pregnancy who have late-life hypertension (n=8, median age=62), second, women with a history of normotensive pregnancy who do not have late-life hypertension (n=32, median age=59), third, women with a history of preeclampsia who have late-life hypertension (n=24, median age=60), and fourth, women with a history of preeclampsia who do not have late-life hypertension (n=16, median age=57). Cerebrovascular disease lesions on MRI, and total gray matter volumes were assessed.Results:Total gray matter volumes were smaller in women with a history of preeclampsia and late-life hypertension compared with the other groups. Voxel-based morphometry demonstrated that the volume changes were localized to the posterior brain regions, particularly the occipital lobe gray matter in women with a history of preeclampsia and late-life hypertension.Conclusion:Having late-life hypertension superimposed on a history of preeclampsia affects the brain structure differently than having either a history of preeclampsia alone or a history of normotensive pregnancy either with or without late-life hypertension.