Age-independent association of pulse pressure with cerebral white matter lesions in asymptomatic elderly individuals

Abstract

Brachial pulse pressure (PP) is a marker of arterial stiffness in the elderly and a useful tool for measuring vascular aging. The presence of cerebral white matter lesions (WMLs) is a radiological marker of sub-clinical ischemic brain damage. WMLs may be age-related degenerative change, but few studies have addressed the relationship between vascular aging and WMLs. In this study, we assessed whether brachial PP is associated with the presence of WMLs in the elderly. Six hundred and ninety-two asymptomatic elderly individuals (>55 years) who visited for routine health check-up were included. Brachial blood pressure (BP) was measured and brain MRI used to determine the presence of advanced WMLs. Ninety-six (13.9%) were found to have advanced WMLs. In the highest PP quartile (≥54 mmHg), 55 (32.9%) had advanced WMLs, and this was significantly higher than in other quartiles. After controlling for age, hypertension, systolic BP, diastolic BP, aspirin use, C-reactive protein, and other vascular risk factors, the highest quartile of PP was significantly associated with advanced WMLs compared with the lowest quartile [adjusted odds ratio (OR) 2.55; 95% confidence interval (CI) 1.03-6.30]. The authors report for the first time that increased brachial PP is an age-independently associated with WMLs in asymptomatic elderly individuals. This result suggests that PP as a presumed marker of vascular aging may predict the presence of sub-clinical cerebrovascular diseases.