Inter‐Relations of Orthostatic Blood Pressure Change, Aortic Stiffness, and Brain Structure and Function in Young Adults

Autor: Naomi M. Hamburg, Alyssa A. Torjesen, Charles DeCarli, Jayandra J. Himali, Gary F. Mitchell, Leroy L. Cooper, Connie W. Tsao, Matthew P. Pase, Ramachandran S. Vasan, Sudha Seshadri, Alexa S. Beiser
Rok vydání: 2017
Předmět:
Male
Aging
Epidemiology
Magnetic Resonance Imaging (MRI)
Hemodynamics
Cardiorespiratory Medicine and Haematology
030204 cardiovascular system & hematology
Cardiovascular
Hypotension
Orthostatic
Executive Function
Orthostatic vital signs
0302 clinical medicine
Risk Factors
magnetic resonance imaging
Young adult
Cognitive impairment
Original Research
Age Factors
Brain
Middle Aged
Massachusetts
Cardiology
Biomedical Imaging
Female
Orthostatic blood pressure
Aortic stiffness
Hypotension
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
aortic stiffness
Orthostatic
Posture
Brain Structure and Function
Pulse Wave Analysis
orthostatic hypotension
03 medical and health sciences
Vascular Stiffness
Vascular Biology
Predictive Value of Tests
Clinical Research
Internal medicine
medicine
Humans
Arterial Pressure
cognitive impairment
Trail Making Test
business.industry
aging
Neurosciences
Cerebrovascular Disorders
Logistic Models
Cross-Sectional Studies
Blood pressure
Multivariate Analysis
Linear Models
Physical therapy
Cognition Disorders
business
030217 neurology & neurosurgery
Zdroj: Journal of the American Heart Association, vol 6, iss 8
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
DOI: 10.1161/jaha.117.006206
Popis: Background Relations of orthostatic change in blood pressure with brain structure and function have not been studied thoroughly, particularly in younger, healthier individuals. Elucidation of factors that contribute to early changes in brain integrity may lead to development of interventions that delay or prevent cognitive impairment. Methods and Results In a sample of the Framingham Heart Study Third Generation (N=2119; 53% women; mean age±SD, 47±8 years), we assessed orthostatic change in mean arterial pressure ( MAP ), aortic stiffness (carotid‐femoral pulse wave velocity), neuropsychological function, and markers of subclinical brain injury on magnetic resonance imaging. Multivariable regression analyses were used to assess relations between orthostatic change in MAP and brain structural and neuropsychological outcomes. Greater orthostatic increase in MAP on standing was related to better Trails B‐A performance among participants aged SE , 0.062±0.029; P =0.031) and among participants with carotid‐femoral pulse wave velocity SE , 0.063±0.026; P =0.016). This relation was not significant among participants who were older or had stiffer aortas. Conversely, greater orthostatic increase in MAP was related to larger total brain volume among older participants (β± SE , 0.065±0.029; P =0.023) and among participants with carotid‐femoral pulse wave velocity ≥6.9 m/s (β± SE , 0.078±0.031; P =0.011). Conclusions Blunted orthostatic increase in MAP was associated with smaller brain volume among participants who were older or had stiffer aortas and with poorer executive function among persons who were younger or who had more‐elastic aortas. Our findings suggest that the brain is sensitive to orthostatic change in MAP , with results dependent on age and aortic stiffness.
Databáze: OpenAIRE
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