Blood pressure variability and functional network connectivity in older adults

Abstract

AbstractBackgroundBlood pressure variability is an emerging risk indicator for cerebrovascular disease and Alzheimer’s disease, independent of traditionally studied mean blood pressure levels. Recent studies suggest elevated blood pressure variability in older adults is also associated with attenuated cerebrovascular reactivity, which may have implications for functional hyperemia underpinning brain network connectivity. However, it remains unclear whether blood pressure variability is related to functional network connectivity. We examined relationships between beat‐to‐beat blood pressure variability in older adults and functional connectivity in multiple brain networks vulnerable to Alzheimer’s disease and related disorders (AD/ADRD).Method32 community‐dwelling older adults (mean [SD] age = 69.6 [7.5] years) without history of dementia or clinical stroke underwent continuous blood pressure monitoring during a 5‐minute period of rest and resting state fMRI. Blood pressure variability was calculated as variability independent of mean, an increasingly used index of variability uncorrelated with mean blood pressure levels. Functional connectivity was determined by resting state fMRI for several brain networks: default mode, salience, dorsal attention, fronto‐parietal, and language. Multiple linear regression examined relationships between blood pressure variability and functional network connectivity, controlling for age, sex, and mean blood pressure. Associations with mean blood pressure were also explored to directly compare potential effects with blood pressure variability.ResultElevated blood pressure variability was associated with lower functional connectivity in the default mode network (ß = ‐.55 [‐1.02, ‐.08]; p = .02). There were no significant associations between blood pressure variability and connectivity in other functional networks (p’s = .10 ‐ .62). Mean blood pressure was not related to functional connectivity in any network (p’s = .08 ‐ .98).ConclusionOlder adults with elevated blood pressure variability exhibit resting state functional connectivity deficits in the default mode network. Findings add to literature supporting the role of blood pressure variability in neurovascular dysfunction and AD/ADRD. Blood pressure variability may represent an important but understudied early vascular risk factor for neurovascular dysfunction relevant to AD/ADRD, with potential therapeutic implications.