Abstract
[Figure: see text].
Highlights
Small vessel disease and related stroke and dementia risks are linked to aging and hypertension, but it is unclear whether the pulsatile or steady blood pressure (BP) component is more important for the development of macrostructural hyperintensities and microstructural white matter damage
Direct injury to small perforating vessels cannot be readily visualized in vivo and, the extent and progress of the small vessel disease (SVD) are often estimated by assessing the damage to the brain parenchyma using neuroimaging techniques, such as magnetic resonance imaging (MRI).[1,3,4]
Pulsatile and steady blood pressure components were associated with white matter damage, with pulse pressure augmenting the effect of age
Summary
Small vessel disease and related stroke and dementia risks are linked to aging and hypertension, but it is unclear whether the pulsatile or steady blood pressure (BP) component is more important for the development of macrostructural hyperintensities and microstructural white matter damage. Direct injury to small perforating vessels cannot be readily visualized in vivo and, the extent and progress of the SVD are often estimated by assessing the damage to the brain parenchyma using neuroimaging techniques, such as magnetic resonance imaging (MRI).[1,3,4] SVD manifests as white matter hyperintensities (WMH) on structural MRI and as microstructural changes on diffusion imaging (dMRI) Both macrostructural and microstructural damage are strongly associated with advancing age and hypertension; it is unclear whether the pulsatile or steady blood pressure (BP) component of hypertension is more important for the development of SVD and associated negative clinical outcomes.[5,6,7] Pulse pressure (PP) is a risk factor for stroke and other cardiovascular events, independent of mean arterial pressure (MAP).[8] Elevated PP reflects increasing arterial stiffness[9] and transmission of pulsatile blood flow to the periphery.. High steady blood pressure was associated with damage to neurite organization and higher white matter hyperintensity volume
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