Abstract
Objective: To test whether elevated blood pressure (BP) relates to grey matter volume (GMV) changes in young adults who had not previously been diagnosed as hypertensive (systolic BP (SBP)/diastolic BP (DBP)≥140/90 mmHg). Methods: We associated BP with GMV from structural 3 Tesla T1-weighted MRI of 423 healthy adults between 19-40 years (mean age=27.7±5.3 years, 177 women, SBP/DBP=123.2/73.4±12.2/8.5 mmHg). Data originated from four previously unpublished cross-sectional studies conducted in Leipzig, Germany. We performed voxel-based morphometry on each study separately and combined results in image-based meta-analyses (IBMA) to assess cumulative effects across studies. Resting BP was assigned to one of four categories: (1) SBP<120 and DBP<80 mmHg, (2) SBP 120-129 or DBP 80-84 mmHg, (3) SBP 130-139 or DBP 85-89 mmHg, (4) SBP≥140 or DBP≥90 mmHg. Results: IBMA yielded: (a) lower regional GMV was correlated with higher peripheral BP; (b) lower GMV with higher BP when comparing individuals in sub-hypertensive categories 3 and 2, respectively, to those in category 1; (c) lower BP-related GMV was found in regions including hippocampus, amygdala, thalamus, frontal and parietal structures (e.g. precuneus). Conclusions: BP≥120/80 mmHg was associated with lower GMV in regions that have previously been related to GM decline in older individuals with manifest hypertension. Our study shows that BP-associated GM alterations emerge continuously across the range of BP and earlier in adulthood than previously assumed. This suggests that treating hypertension or maintaining lower BP in early adulthood might be essential for preventing the pathophysiological cascade of asymptomatic cerebrovascular disease to symptomatic end-organ damage, such as stroke or dementia.
