Multiscale Dynamics of Blood Pressure Fluctuation Is Associated With White Matter Lesion Burden in Older Adults With and Without Hypertension: Observations From a Pilot Study

Jiang，Xin1,2,3; Guo，Yi2,3,4,5; Zhao，Yue6; Gao，Xia1,2,3; Peng，Dan1,2,3; Zhang，Hui2,3,4; Deng，Wuhong1,2,3; Fu，Wen1,2,3; Qin，Na1,2,3; Chang，Ruizhen1,2,3; Manor，Brad7,8; Lipsitz，Lewis A.7,8; Zhou，Junhong7,8

2021-02-26

10.3389/fcvm.2021.636702

Frontiers in Cardiovascular Medicine   Impact Factor & Quartile

2297-055X

Background: White matter lesions (WMLs) are highly prevalent in older adults, and hypertension is one of the main contributors to WMLs. The blood pressure (BP) is regulated by complex underlying mechanisms over multiple time scales, thus the continuous beat-to-beat BP fluctuation is complex. The association between WMLs and hypertension may be manifested as diminished complexity of BP fluctuations. The aim of this pilot study is to explore the relationships between hypertension, BP complexity, and WMLs in older adults. Method: Fifty-three older adults with clinically diagnosed hypertension and 47 age-matched older adults without hypertension completed one MRI scan and one BP recording of 10–15 min when sitting quietly. Their cerebral WMLs were assessed by two neurologists using the Fazekas scale based on brain structural MRI of each of their own. Greater score reflected higher WML grade. The complexity of continuous systolic (SBP) and diastolic (DBP) BP series was quantified using multiscale entropy (MSE). Lower MSE reflected lower complexity. Results: Compared to the non-hypertensive group, hypertensives had significantly greater Fazekas scores (F > 5.3, p < 0.02) and lower SBP and DBP complexity (F > 8.6, p < 0.004). Both within each group (β < −0.42, p < 0.01) and across groups (β < −0.47, p < 0.003), those with lower BP complexity had higher Fazekas score. Moreover, complexity of both SBP and DBP mediated the influence of hypertension on WMLs (indirect effects > 0.25, 95% confidence intervals = 0.06 – 0.50). Conclusion: These results suggest that diminished BP complexity is associated with WMLs and may mediate the influence of hypertension on WMLs. Future longitudinal studies are needed to examine the causal relationship between BP complexity and WMLs.

beat-to-beat blood pressure fluctuation hypertension multiscale entropy older adults white matter lesions

SCI

English

Corresponding

Natural Science Foundation of Shenzhen City[JCYJ20170818111012390];Sanming Project of Medicine in Shenzhen[SZSM201812039];

WOS:000627580700001

2-s2.0-85111361675

Scopus

1.Department of Geriatrics,Shenzhen People's Hospital,Shenzhen,China
2.The Second Clinical Medical College,Jinan University,Shenzhen,China
3.The First Affiliated Hospital,Southern University of Science and Technology,Shenzhen,China
4.Department of Neurology,Shenzhen People's Hospital,Shenzhen,China
5.Shenzhen Bay Laboratory,Shenzhen,China
6.Department of Electrical and Computer Engineering,University of Rochester,Rochester,United States
7.Hinda and Arthur Marcus Institute for Aging Research,Hebrew SeniorLife,Boston,United States
8.Division of Gerontology,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,United States

Jiang，Xin,Guo，Yi,Zhao，Yue,et al. Multiscale Dynamics of Blood Pressure Fluctuation Is Associated With White Matter Lesion Burden in Older Adults With and Without Hypertension: Observations From a Pilot Study[J]. Frontiers in Cardiovascular Medicine,2021,8.

Jiang，Xin.,Guo，Yi.,Zhao，Yue.,Gao，Xia.,Peng，Dan.,...&Zhou，Junhong.(2021).Multiscale Dynamics of Blood Pressure Fluctuation Is Associated With White Matter Lesion Burden in Older Adults With and Without Hypertension: Observations From a Pilot Study.Frontiers in Cardiovascular Medicine,8.

Jiang，Xin,et al."Multiscale Dynamics of Blood Pressure Fluctuation Is Associated With White Matter Lesion Burden in Older Adults With and Without Hypertension: Observations From a Pilot Study".Frontiers in Cardiovascular Medicine 8(2021).