Abstract 061: Continuous And Cyclic Components Of Blood Pressure Profile Have Impact On Different Brain Areas In Controlled Hypertensive Patients

Abstract

Increase in arterial blood pressure consistently damages the connectivity and function of the brain. While this evidence is becoming more widely accepted, the effects of daily fluctuations and variability in blood pressure levels on the brain are still not well understood. Our study investigated the impact of blood pressure variability (BPV) on cognitive function and white matter brain structure in a cohort of hypertensive patients under optimal BP control. We used diffusion tensor imaging (DTI-MRI) to assess white matter injury, neuropsychological tests such as the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function, and 24-hour ambulatory blood pressure monitoring to measure BPV. Spectral analysis of BPV allowed us to measure both the cyclic and the continuous components of arterial blood pressure profile. We found that the Fractional Anisotropy of the Middle Cerebellar Peduncle was correlated with the cyclic component of both diastolic and systolic blood pressure. Additionally, a significant association between the continuous component of both diastolic and systolic blood pressure and the Anterior Thalamic Radiation was detected.. Finally, cognitive functions measured by MoCA were correlated with the continuous component of both diastolic and systolic blood pressure (Table). Our results suggest that the continuous component of blood pressure negatively impacts white matter regions associated with cognitive impairment, while the cyclic component is associated with alterations in brainstem regions where nervous vagal control is coordinated.