News | Magnetic Resonance Imaging (MRI) | January 08, 2019

Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk

Researchers found patients with a progression of abnormalities in periventricular white matter disease on MRI had a six-fold increased risk of cognitive decline

Hypertension With Progressive Cerebral Small Vessel Disease Increases Cognitive Impairment Risk

January 8, 2019 – Patients with high blood pressure and progression of periventricular white matter hyperintensities showed signs of cognitive impairment despite taking medication to lower their blood pressure, according to new research in the American Heart Association’s journal Hypertension.1

High blood pressure has been linked to an increased risk for dementia, but what’s unclear is what kinds of subtle negative changes take place in the brain that may affect cognitive function. Finding new ways to detect minor types of cognitive impairment may help determine who is at risk for early-stage dementia.

In this study, researchers looked at 345 men and women with a median age of 65 who had high blood pressure. Patients underwent brain magnetic resonance imaging (MRI) scans, were tested in cognitive function areas including execution, memory and attention, and were followed for about four years. Patients’ average blood pressure during follow-up was 144.5/76.5 mm Hg. The American Heart Association/American College of Cardiology 2017 hypertension guidelines revised the definition of hypertension and classified it as a blood pressure reading of 130/80 mm Hg instead of 140/90.

To understand what was going on in the brain, researchers looked at the brain’s white matter. White matter is important because it connects different regions of the brain, serving as a kind of infrastructure. Specifically, researchers looked at periventricular white matter, located in the central part of the brain. Periventricular white matter acts as a bridge between distant brain regions and serves an important role in cognitive function. Lesions or abnormalities found in periventricular white matter could signal cognitive impairment.

During the study, 9 percent of the group developed mild cognitive impairment which may increase the risk for dementia. There was also a connection for periventricular white matter changes and the risk of mild cognitive impairment. Researchers found that patients with a progression of periventricular white matter abnormalities showed a six-fold increased risk of mild cognitive decline.

The study observed that the progression of periventricular white matter abnormalities aligned with cognitive decline in global and executive function; small vessel bleeding in the brain was found to be related to a decline in attention.

Although the development of brain lesions may be considered “silent” conditions in which patients do not feel or are unaware of symptoms, if left untreated, the risks of more severe forms of cognitive decline may increase. Researchers say more study is needed to better understand how periventricular white matter changes triggers cognitive decline.

“The brain is an organ exposed to a high volume of blood flow and it is very vulnerable to sustained high blood pressure levels, and this might be happening silently or with mild symptoms, but that doesn’t mean there aren’t consequences,” said lead author Joan Jiménez Balado, Ph.D. student, psychologist, M.Sc. in neuroscience at the Institut de Recerca Hospital Vall d'Hebron in Barcelona, Spain. “High blood pressure and its consequences are really ‘covert’ diseases that tend to progress if it is not well managed.”

For more information: www.ahajournals.org/journal/hyp

 

Reference

1. Jiménez-Balado J., Riba-Llena I., Abril O., et al. Cognitive Impact of Cerebral Small Vessel Disease Changes in Patients With Hypertension. Hypertension, Jan. 4, 2019. https://doi.org/10.1161/HYPERTENSIONAHA.118.12090

Related Content

FDA Clears Advancements for Viewray MRIdian Radiation Therapy System
Technology | Image Guided Radiation Therapy (IGRT) | February 21, 2019
February 21, 2019 — ViewRay Inc. received 510(k) clearance from the U.S.
MRI and Computer Modeling Reveals How Wrist Bones Move

Using fast MRI, UC Davis researchers scanned left and right wrists of men and women and used the data to build computer models of the movement of wrist bones. The data could help understand wrist injuries such as carpal tunnel syndrome. Image courtesy of Brent Foster and Abhijit Chaudhari, UC Davis.

News | Magnetic Resonance Imaging (MRI) | February 19, 2019
In a just-published Journal of Biomechanics article, the researchers proved a longtime assumption about individuals'...
Amazon Comprehend Medical Brings Medical Language Processing to Healthcare
News | Artificial Intelligence | February 15, 2019
Amazon recently announced Amazon Comprehend Medical, a new HIPAA-eligible machine learning service that allows...
Videos | Radiation Therapy | February 15, 2019
ITN Associate Editor Jeff Zagoudis speaks with Vinai Gondi, M.D., director of research and CNS neuro-oncology at the
Siemens Healthineers Demonstrates Artificial Intelligence, Healthcare Digitalization at HIMSS19
News | Artificial Intelligence | February 13, 2019
February 13, 2019 — At the 2019 Healthcare Information and Management Systems Society (HIMSS) global conference and e
Videos | Angiography | February 08, 2019
This is an example of an arterial venous malformation (AVM) in the brain imaged on a...
Fujifilm Launches Latest Synapse 3D Version at HIMSS 2019

The new Intravoxel Incoherent Motion (IVIM) MR application in Synapse 3D

Technology | Advanced Visualization | February 08, 2019
Fujifilm Medical Systems U.S.A. will debut the latest version of its Synapse 3D solution at the Healthcare Information...
Medtronic Recalls Synergy Cranial Software and Stealth Station S7 Cranial Software
News | Procedure Navigation Systems | February 05, 2019
Medtronic is recalling the Synergy Cranial Software and StealthStation S7 Cranial Software used with the StealthStation...
Study Assesses Risk of MRI Exams for Patients With Tattoos
News | Magnetic Resonance Imaging (MRI) | February 01, 2019
A new European study concluded that magnetic resonance imaging (MRI) exams pose little risk for people with tattoos,...
Stereotactic Radiotherapy Improves Long-Term Survival in Stage-IV Cancers
News | Stereotactic Body Radiation Therapy (SBRT) | January 31, 2019
The first report from a phase II, multi-center clinical trial indicates stereotactic radiation can extend long-term...