From the Departments of Psychiatry and Biobehavioral Sciences (I.B.G.,
G.B., D.S.) and Radiology (D.B.H.), University of California, Los Angeles, and
the Research Service, West Los Angeles VA Medical Center (G.B.), Los Angeles,
Calif.
Correspondence to Iris B. Goldstein, PhD, UCLA Department of Psychiatry, 760 Westwood Plaza, Los Angeles, CA 90024-1759. E-mail irisg{at}ucla.edu.
Background and Purpose—The
relationship between blood pressure (BP) and heart rate (HR) and MRI
assessments of subcortical T2 hyperintensities was evaluated in healthy
elderly men and women.
Methods—Casual and 24-hour ambulatory BPs and HR measurements
were taken of 144 elderly individuals, aged 55 to 79 years. Subjects
had no evidence of previous health disorders. MRI scans of white
matter, subcortical gray matter, and insular subcortex were coded for
severity of hyperintensities.
Results—Mean casual BP for the group was 120/72 mm Hg. With
age and sex accounted for, individuals with the highest severity rating
of white matter hyperintensities had higher casual, awake, and sleep
systolic BPs; higher awake diastolic BPs; greater
awake systolic BP variability; and a smaller nocturnal fall in
systolic and diastolic BPs than individuals with
less severe ratings. Higher severity ratings for subcortical gray
matter hyperintensities were associated with elevations in casual,
awake, and asleep systolic BPs and a smaller HR drop during
sleep. Subjects with higher ratings for the insular subcortex had
higher systolic and diastolic BPs (casual, awake,
and asleep), greater HR variability during sleep, and a smaller
nocturnal fall in HR.
Conclusions—Casual and 24-hour ambulatory BPs and some ambulatory
HR measures are associated with subcortical lesions of the brain.
Longitudinal studies are needed to further explore the relationship
between white matter lesions and cardiovascular
measures, as well as the significance of these lesions for
cerebrovascular disease in healthy elderly subjects.
© 1998 American Heart Association, Inc.
Original Contributions
Relationship Between Blood Pressure and Subcortical Lesions in Healthy Elderly People
Key Words: blood pressure • elderly • heart rate • magnetic resonance imaging
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