Abstract

AbstractBackgroundHypertension is a well‐established risk factor for cognitive impairment, brain atrophy and dementia. Isolated hypertension is where either systolic or diastolic blood pressure is high and the other measure is normal. It is unknown the impact of isolated hypertension on brain atrophy and how it compares to non isolated hypertension (NIH). Therefore it is important to investigate the impact of isolated hypertension to help understand its impact on future dementia risk and cognitive decline. We investigated relationships between isolated hypertension on brain volumes using the largest cohort of healthy individuals from the United Kingdom.MethodUsing the UK Biobank cohort, we carried out a cross‐sectional study using 31,513 participants [mean age 63 years, 53% female] with BP measurements and brain MRI data. We used linear regression models to determine the associations between isolated systolic (ISH) and isolated diastolic hypertension (IDH) split by BP medication use with brain volumes (total volume, total grey matter, hippocampal and white matter hyperintensities (WMH)).ResultIndividuals with ISH and taking BP medications (n = 3137) had smaller grey matter volumes (β = ‐0.04 [95%CI ‐0.07 to ‐0.03]), and greater WMH (β = 0.25 [95%CI 0.21 to 0.28]) compared to normotensive individuals (n = 14677). Interestingly, individuals with IDH and taking BP medications (n =140) also had smaller total grey matter (β = ‐0.11 [95%CI ‐0.19 to ‐0.04]) and larger WMH (β = 0.26 [95%CI 0.12 to 0.41]). Individuals with ISH have comparable total grey matter atrophy to individuals with NIH not taking medications (ISH β = ‐0.044 vs NIH β = ‐0.027) and have comparable WMHs (ISH β = 0.25 vs NIH β = 0.022).ConclusionOur results indicate that individuals with isolated hypertension have greater total grey matter atrophy and vascular pathology and this atrophy is similar to certain subsets of individuals with non isolated hypertension. These results provide a further emphasis of preventative strategies particularly focusing on isolated systolic hypertension as well as non isolated hypertension in maintaining brain health to reduce dementia risk earlier in life.

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