Life-course blood pressure in relation to brain volumes

Introduction: The impact of blood pressure on brain volumes may be time-dependent or pattern dependent. Methods: Of 1678 participants from the Atherosclerosis Risk in Communities Neurocognitive Study, we quantified the association between measures and patterns of blood pressure over three time points (similar to 24 or similar to 15 years prior and concurrent with neuroimaging) with late life brain volumes. Results: Higher diastolic blood pressure similar to 24 years prior, higher systolic and pulse pressure similar to 15 years prior, and consistently elevated or rising systolic blood pressure from similar to 15 years prior to concurrent with neuroimaging, but not blood pressures measured concurrent with neuroimaging, were associated with smaller volumes. The pattern of hypertension similar to 15 years prior and hypotension concurrent with neuroimaging was associated with smaller volumes in regions preferentially affected by Alzheimer's disease (e.g., hippocampus: -0.27 standard units, 95% CI: -0.51, -0.03). Discussion: Hypertension 15 to 24 years prior is relevant to current brain volumes. Hypertension followed by hypotension appears particularly detrimental. (C) 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.