- In patients with hypertension, progressive periventricular white matter disease (WMD) on MRI is linked to a 6-fold increase in risk for cognitive decline, even if they’re taking antihypertensives.
Why this matters
- Hypertension has been tied to increased dementia risk, but any subtle brain changes that underlie the link have been unclear.
- 9.1% had WMDs.
- Compared with patients with no progression, participants with more periventricular white matter hyperintensities (WMHs) had greater risk for:
- Mild cognitive decline: OR, 6.184 (95% CI, 1.506-25.370; P=.011), and
- Global cognitive function: adjusted mean (standard error), −0.519 (0.176) vs 0.057 (0.044), respectively (P=.004).
- Data from ISSYS (Investigating Silent Strokes in Hypertensives: a Magnetic Resonance Imaging Study), n=345 (median age, 65 years), average BP 144.5/76.5 mmHg.
- WMHs on brain MRI graded as none, minor, or marked at baseline and follow-up.
- Cognitive testing and diagnosis performed.
- Funding: Instituto de Salud Carlos III, European Regional Development Fund.
- Generalizability is not clear.
- Some potential sources of bias.