Cardiovascular risk factors and small vessel disease of the brain: Blood pressure, white matter lesions, and functional decline in older persons

被引：146

作者：

Abraham, Hazel Mae A. ^{[1
,2
]}

Wolfson, Leslie ^{[3
]}

Moscufo, Nicola ^{[4
]}

Guttmann, Charles R. G. ^{[4
]}

Kaplan, Richard F. ^{[5
]}

White, William B. ^{[1
,2
]}

机构：

[1] Univ Connecticut, Sch Med, Calhoun Cardiol Ctr, Farmington, CT 06030 USA

[2] Univ Connecticut, Sch Med, Dept Med, Farmington, CT 06030 USA

[3] Univ Connecticut, Sch Med, Dept Neurol, Farmington, CT 06030 USA

[4] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Radiol, Boston, MA 02115 USA

[5] Univ Connecticut, Sch Med, Dept Psychiat, Farmington, CT 06030 USA

来源：

JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM | 2016年 / 36卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Ambulatory blood pressure; cerebral small vessel disease (SVD); cognitive function; mobility; systolic hypertension; white matter hyperintensity lesions; C-REACTIVE PROTEIN; COGNITIVE DECLINE; CEREBROVASCULAR-DISEASE; HYPERINTENSITY VOLUME; ELDERLY-PEOPLE; HOMOCYSTEINE; ASSOCIATION; GENE; MRI; AGE;

D O I：

10.1038/jcbfm.2015.121

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Several potential vascular risk factors exist for the development and accumulation of subcortical white matter disease in older people. We have reported that in older people followed for up to 4 years white matter hyperintensity (WMH) lesions on magnetic resonance imaging nearly doubled in volume and were associated with alterations in mobility and cognitive function. Herein we review the genetic, metabolic, and vascular risk factors that have been evaluated in association with the development and pathogenesis of WMH in older persons. Our research efforts have focused on systemic hypertension, particularly in the out-of-office setting as 24-hour ambulatory blood pressure (BP) has proven to be a stronger indicator of the progression of WMH in older people and the associated functional decline than doctor's office BP. Based on relations between 24-hour systolic BP levels, the accrual of WMH, and functional decline, we have designed the INFINITY trial, the first interventional study to use ambulatory BP to guide antihypertensive therapy to address this problem in the geriatric population.

引用

页码：132 / 142

页数：11

共 71 条

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