Hypertension and cerebral white matter lesions in a prospective cohort study

作者：F.‐E. de Leeuw, Jan Cees de Groot, Matthijs Oudkerk, J. C. M. Witteman, Albert Hofman, J. van Gijn, Monique M.B. Breteler · 发表于：Brain · 年份：2002 · DOI：10.1093/brain/awf077 · 被引用次数：607 · 研究领域：Dementia and Cognitive Impairment Research、Neurological Disease Mechanisms and Treatments、Cerebrovascular and Carotid Artery Diseases

White matter lesions are frequently found on cerebral MRI scans of elderly people and are thought to be important in the pathogenesis of dementia. Hyper tension has been associated with the presence of white matter lesions but this has been investigated almost exclusively in cross-sectional studies. We studied prospectively the association of these lesions with the duration and treatment of hypertension. We randomly sampled 1077 subjects aged between 60 and 90 years from two prospective population-based studies. One-half of the study subjects had their blood pressure measured between 1975 and 1978 and the other half between 1990 and 1993. All subjects underwent 1.5 T MRI scanning; white matter lesions in the subcortical and periventricular regions were rated separately. Subjects with hypertension had increased rates of both types of white matter lesion. Duration of hypertension was associated with both periventricular and subcortical white matter lesions. This relationship was influenced strongly by age. For participants with >20 years of hypertension and aged between 60 and 70 years at the time of follow-up, the relative risks for subcortical and periventricular white matter lesions were 24.3 [95% confidence interval (CI) 5.1-114.8] and 15.8 (95% CI 3.4-73.5), respectively, compared with normotensive subjects. Subjects with successfully treated hypertension had only moderately increased rates of subcortical white matter lesions and periventricular white matter lesions (relat...