Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults
Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.
Author Disclosures: M.R. Raman: None. J. Graff-Radford: None. S.A. Przybelski: None. T.G. Lesnick: None. M.M. Mielke: Research Grant; Significant; NIH, DOD, Michael J. Fox Foundation. Consultant/Advisory Board; Significant; Lysosomal Therapeutics. R.O. Roberts: None. B.F. Boeve: Research Grant; Significant; NIA. Honoraria; Modest; American Academy of Neurology. Consultant/Advisory Board; Modest; Tau Consortium. Consultant/Advisory Board; Significant; Cephalon, Inc., Allon Pharmaceuticals, GE Healthcare. D.S. Knopman: Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Lundbeck Pharmaceuticals, Lilly Pharmaceuticals, Alzheimer’s Disease Cooperative Study. R.C. Petersen: Research Grant; Significant; NIH. Consultant/Advisory Board; Significant; Roche, Inc, Merck, Inc, Genentech, Inc, Biogen, Inc, Eli Lilly and Company. J.E. Parisi: None. D.W. Dickson: Research Grant; Significant; NIH, CurePSP/Society for Supranuclear Palsy. C.R. Jack: Research Grant; Significant; NIH, Alexander Family Alzheimer’s Disease Research Professorship of the Mayo Foundation Family. Consultant/Advisory Board; Significant; Eli Lilly. K. Kantarci: Research Grant; Significant; NIH, Minnesota Partnership. Consultant/Advisory Board; Significant; Pfizer, Inc., Takeda Global Research & Development Center, Inc..
- © 2017 by American Heart Association, Inc.