Dataset Information

Pulse Pressure, Cognition, and White Matter Lesions: A Mediation Analysis.

ABSTRACT: This study aimed to investigate the effects of pulse pressure (PP) on cognition and the role of white matter lesions (WMLs) in mediating this association. We enrolled 3,009 participants from the SPRINT-MIND study. Of those, 755 participants underwent brain magnetic resonance imaging. Cognitive tests were summarized in five cognition domains, including global cognition, executive function, attention, memory, and language. Multiple linear regression models were employed to analyze PP in association with cognition, and mediation analysis was applied to determine the role of WMLs in the association between PP and cognition. We found that PP was negatively linearly associated with global cognition (β = -0.048, P = 0.008), executive function (β = -0.014, P = 0.040), attention (β = -0.013, P = 0.035), memory (β = -0.021, P = 0.045), and language (β = -0.020, P = 0.001), respectively. Furthermore, PP was not significantly associated with brain component volume changes, except for WMLs (β = 0.029, P = 0.044). Additionally, mediation analysis showed that increased WML volume contributed to 10.8% of global cognition, 9.5% of executive function, 10.6% of memory, and 7.2% of language decline associated with PP. Exposure to higher PP levels was associated with poor cognitive performance, and WMLs partially moderated the influence of PP on cognition.

SUBMITTER: Zang J

PROVIDER: S-EPMC8130823 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Pulse Pressure, Cognition, and White Matter Lesions: A Mediation Analysis.

Zang Jiabin J Shi Jian J Liang Jianwen J Zhang Xiaocong X Wei Wenbin W Yao Chun C Zhuang Xiaodong X Wu Guifu G

Frontiers in cardiovascular medicine 20210504

This study aimed to investigate the effects of pulse pressure (PP) on cognition and the role of white matter lesions (WMLs) in mediating this association. We enrolled 3,009 participants from the SPRINT-MIND study. Of those, 755 participants underwent brain magnetic resonance imaging. Cognitive tests were summarized in five cognition domains, including global cognition, executive function, attention, memory, and language. Multiple linear regression models were employed to analyze PP in associatio ...[more]

PMID: 34017867

Similar Datasets

Project description:ImportanceThe effect of intensive blood pressure lowering on brain health remains uncertain.ObjectiveTo evaluate the association of intensive blood pressure treatment with cerebral white matter lesion and brain volumes.Design, setting, and participantsA substudy of a multicenter randomized clinical trial of hypertensive adults 50 years or older without a history of diabetes or stroke at 27 sites in the United States. Randomization began on November 8, 2010. The overall trial was stopped early because of benefit for its primary outcome (a composite of cardiovascular events) and all-cause mortality on August 20, 2015. Brain magnetic resonance imaging (MRI) was performed on a subset of participants at baseline (n = 670) and at 4 years of follow-up (n = 449); final follow-up date was July 1, 2016.InterventionsParticipants were randomized to a systolic blood pressure (SBP) goal of either less than 120 mm Hg (intensive treatment, n = 355) or less than 140 mm Hg (standard treatment, n = 315).Main outcomes and measuresThe primary outcome was change in total white matter lesion volume from baseline. Change in total brain volume was a secondary outcome.ResultsAmong 670 recruited patients who had baseline MRI (mean age, 67.3 [SD, 8.2] years; 40.4% women), 449 (67.0%) completed the follow-up MRI at a median of 3.97 years after randomization, after a median intervention period of 3.40 years. In the intensive treatment group, based on a robust linear mixed model, mean white matter lesion volume increased from 4.57 to 5.49 cm3 (difference, 0.92 cm3 [95% CI, 0.69 to 1.14]) vs an increase from 4.40 to 5.85 cm3 (difference, 1.45 cm3 [95% CI, 1.21 to 1.70]) in the standard treatment group (between-group difference in change, -0.54 cm3 [95% CI, -0.87 to -0.20]). Mean total brain volume decreased from 1134.5 to 1104.0 cm3 (difference, -30.6 cm3 [95% CI, -32.3 to -28.8]) in the intensive treatment group vs a decrease from 1134.0 to 1107.1 cm3 (difference, -26.9 cm3 [95% CI, 24.8 to 28.8]) in the standard treatment group (between-group difference in change, -3.7 cm3 [95% CI, -6.3 to -1.1]).Conclusions and relevanceAmong hypertensive adults, targeting an SBP of less than 120 mm Hg, compared with less than 140 mm Hg, was significantly associated with a smaller increase in cerebral white matter lesion volume and a greater decrease in total brain volume, although the differences were small.Trial registrationClinicalTrials.gov Identifier: NCT01206062.

Dataset Information

Pulse Pressure, Cognition, and White Matter Lesions: A Mediation Analysis.

Publications

Pulse Pressure, Cognition, and White Matter Lesions: A Mediation Analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets