RELATIONSHIP BETWEEN BLOOD-PRESSURE AND SUBCORTICAL LESIONS IN HEALTHY ELDERLY PEOPLE

Background and Purpose-The relationship between blood pressure (BP) an d heart rate (HR) and MRI assessments of subcortical T2 hyperintensiti es was evaluated in healthy elderly men and women. Methods-Casual and 24-hour ambulatory BPs and HR measurements were taken of 144 elderly i ndividuals, aged 55 to 79 years. Subjects had no evidence of previous health disorders. MRT scans of white matter, subcortical gray matter, and insular subcortex were coded for severity of hyperintensities. Res ults-Mean casual BP for the group was 120/72 mm Hg. With age and sex a ccounted for, individuals with the highest severity rating of white ma tter hyperintensities had higher casual, awake, and sleep systolic BPs ; higher awake diastolic BPs; greater awake systolic BP variability; a nd a smaller nocturnal fall in systolic and diastolic BPs than individ uals with less severe ratings, Higher severity ratings for subcortical gray matter hyperintensities were associated with elevations in casua l, awake, and asleep systolic BPs and a smaller HR drop during sleep. Subjects with higher ratings for the insular subcortex had higher syst olic and diastolic BPs (casual, awake, and asleep), greater HR variabi lity during sleep, and a smaller nocturnal fall in HR, Conclusions-Cas ual and 24-hour ambulatory BPs and some ambulatory HR measures are ass ociated with subcortical lesions of the brain. Longitudinal studies ar e needed to further explore the relationship between white matter lesi ons and cardiovascular measures, as well as the significance of these lesions for cerebrovascular disease in healthy elderly subjects.