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96 Short-Term Blood Pressure Variability and Cerebrovascular Health in OlderaAdults

Published online by Cambridge University Press:  21 December 2023

Isabel J Sible ,
Belinda Yew ,
Arunima Kapoor ,
Jung Y Jang ,
John Paul M Alitin ,
Shubir Dutt ,
Yanrong Li ,
Anna E Blanken ,
Jean K Ho  and
Anisa J Marshall
...Show all authors
Isabel J Sible*
Affiliation:
University of Southern California, Los Angeles, CA, USA.
Belinda Yew
Affiliation:
University of Southern California, Los Angeles, CA, USA. Mount Sinai, New York, NY, USA.
Arunima Kapoor
Affiliation:
University of California Irvine, Irvine, CA, USA.
Jung Y Jang
Affiliation:
University of California Irvine, Irvine, CA, USA.
John Paul M Alitin
Affiliation:
University of California Irvine, Irvine, CA, USA.
Shubir Dutt
Affiliation:
University of Southern California, Los Angeles, CA, USA.
Yanrong Li
Affiliation:
University of California Irvine, Irvine, CA, USA.
Anna E Blanken
Affiliation:
San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA. University of California San Francisco, San Francisco, CA, USA.
Jean K Ho
Affiliation:
University of California Irvine, Irvine, CA, USA.
Anisa J Marshall
Affiliation:
University of Southern California, Los Angeles, CA, USA.
Fatemah Shenasa
Affiliation:
University of California Irvine, Irvine, CA, USA.
Aimee Gaubert
Affiliation:
University of California Irvine, Irvine, CA, USA.
Amy Nguyen
Affiliation:
University of California Irvine, Irvine, CA, USA.
Kathleen E Rodgers
Affiliation:
University of Arizona, Tucson, AZ, USA
Virginia E Sturm
Affiliation:
University of California San Francisco, San Francisco, CA, USA.
Daniel A Nation
Affiliation:
University of California Irvine, Irvine, CA, USA.
*
Correspondence: Isabel J Sible University of Southern California sible@usc.edu
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Abstract

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Objective:

Blood pressure variability (BPV), independent of traditionally targeted average blood pressure levels, is an emerging vascular risk factor for stroke, cerebrovascular disease, and dementia, possibly through links with vascular-endothelial injury. Recent evidence suggests visit-to-visit (e.g., over months, years) BPV is associated with cerebrovascular disease severity, but less is known about relationships with short-term (e.g., < 24 hours) fluctuations in blood pressure. Additionally, it is unclear how BPV may be related to angiogenic growth factors that play a role in cerebral arterial health.

Participants and Methods:

We investigated relationships between short-term BPV, white matter hyperintensities on MRI, and levels of plasma vascular endothelial growth factor (VEGF) in a sample of community-dwelling older adults (n = 57, ages 55-88) without history of dementia or stroke. Blood pressure was collected continuously during a 5-minute resting period. BPV was calculated as variability independent of mean, a commonly used index of BPV uncorrelated with average blood pressure levels. Participants underwent T2-FLAIR MRI to determine severity of white matter lesion burden. Severity of lesions was classified as Fazekas scores (0-3). Participants also underwent venipuncture to determine levels of plasma VEGF. Ordinal logistic regression examined the association between BPV and Fazekas scores. Multiple linear regression explored relationships between BPV and VEGF. Models controlled for age, sex, and average blood pressure.

Results:

Elevated BPV was related to greater white matter lesion burden (i.e., Fazekas score) (systolic: OR = 1.17 [95% CI 1.01, 1.37]; p = .04; diastolic: OR = 2.47 [95% CI 1.09, 5.90]; p = .03) and increased levels of plasma VEGF (systolic: ß = .39 [95% CI .11, .67]; adjusted R2 = .16; p = .007; diastolic: ß = .48 [95% CI .18, .78]; adjusted R2 = .18; p = .003).

Conclusions:

Findings suggest short-term BPV may be related to cerebrovascular disease burden and angiogenic growth factors relevant to cerebral arterial health, independent of average blood pressure. Understanding the role of BPV in cerebrovascular disease and vascular-endothelial health may help elucidate the increased risk for stroke and dementia associated with elevated BPV.

Keywords

cerebrovascular disease
Type
Poster Session 01: Medical | Neurological Disorders | Neuropsychiatry | Psychopharmacology
Information
Journal of the International Neuropsychological Society , Volume 29 , Supplement s1: Final Program Fifty First Annual Meeting International Neuropsychological Society February 1–4, 2023 San Diego, CA, USA , November 2023 , pp. 195 - 196
Copyright
Copyright © INS. Published by Cambridge University Press, 2023