Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults)

Yuichiro Yano; Jared P Reis; Deborah A Levine; R Nick Bryan; Anthony J Viera; Daichi Shimbo; Yacob G Tedla; Norrina B Allen; Pamela J Schreiner; Michael P Bancks; Stephen Sidney; Mark J Pletcher; Kiang Liu; Philip Greenland; Donald M Lloyd-Jones; Lenore J Launer

doi:10.1161/HYPERTENSIONAHA.117.10144

Visit-to-Visit Blood Pressure Variability in Young Adulthood and Hippocampal Volume and Integrity at Middle Age: The CARDIA Study (Coronary Artery Risk Development in Young Adults)

Hypertension. 2017 Dec;70(6):1091-1098. doi: 10.1161/HYPERTENSIONAHA.117.10144. Epub 2017 Oct 9.

Authors

Yuichiro Yano¹, Jared P Reis², Deborah A Levine², R Nick Bryan², Anthony J Viera², Daichi Shimbo², Yacob G Tedla², Norrina B Allen², Pamela J Schreiner², Michael P Bancks², Stephen Sidney², Mark J Pletcher², Kiang Liu², Philip Greenland², Donald M Lloyd-Jones², Lenore J Launer²

Affiliations

¹ From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.). yyano@jichi.jp yyano@umc.edu.
² From the Department of Preventive Medicine, University of Mississippi Medical Center, Jackson (Y.Y.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (Y.Y., Y.G.T., N.B.A., M.P.B., K.L., P.G., D.M.L.-J.); Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (J.P.R.); Division of General Medicine, University of Michigan, Ann Arbor (D.A.L.); Department of Radiology, University of Pennsylvania Health System, Philadelphia (R.N.B.); Department of Family Medicine, Hypertension Research Program, University of North Carolina at Chapel Hill (A.J.V.); Department of Medicine, Columbia University Medical Center, New York, NY (D.S.); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (P.J.S.); Division of Research, Kaiser Permanente of Northern California, Oakland (S.S.); Department of Epidemiology and Biostatistics, University of California, San Francisco (M.J.P.); and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD (L.J.L.).

Abstract

The aims of this study are to assess the relationships of visit-to-visit blood pressure (BP) variability in young adulthood to hippocampal volume and integrity at middle age. We used data over 8 examinations spanning 25 years collected in the CARDIA study (Coronary Artery Risk Development in Young Adults) of black and white adults (age, 18-30 years) started in 1985 to 1986. Visit-to-visit BP variability was defined as by SD_BP and average real variability (ARV_BP, defined as the absolute differences of BP between successive BP measurements). Hippocampal tissue volume standardized by intracranial volume (%) and integrity assessed by fractional anisotropy were measured by 3-Tesla magnetic resonance imaging at the year-25 examination (n=545; mean age, 51 years; 54% women and 34% African Americans). Mean systolic BP (SBP)/diastolic BP levels were 110/69 mm Hg at year 0 (baseline), 117/73 mm Hg at year 25, and ARV_SBP and SD_SBP were 7.7 and 7.9 mm Hg, respectively. In multivariable-adjusted linear models, higher ARV_SBP was associated with lower hippocampal volume (unstandardized regression coefficient [standard error] with 1-SD higher ARV_SBP: -0.006 [0.003]), and higher SD_SBP with lower hippocampal fractional anisotropy (-0.02 [0.01]; all P<0.05), independent of cumulative exposure to SBP during follow-up. Conversely, cumulative exposure to SBP and diastolic BP was not associated with hippocampal volume. There was no interaction by sex or race between ARV_SBP or SD_SBP with hippocampal volume or integrity. In conclusion, visit-to-visit BP variability during young adulthood may be useful in assessing the potential risk for reductions in hippocampal volume and integrity in midlife.

Keywords: blood pressure; brain; hippocampus; humans; young adult.

Publication types

Multicenter Study
Research Support, N.I.H., Extramural

MeSH terms

Adolescent
Adult
Aging / physiology*
Blood Pressure / physiology*
Coronary Artery Disease / diagnosis
Coronary Artery Disease / epidemiology*
Female
Follow-Up Studies
Hippocampus / diagnostic imaging*
Humans
Incidence
Magnetic Resonance Imaging
Male
Middle Aged
Office Visits*
Organ Size
Retrospective Studies
Risk Factors
Time Factors
United States / epidemiology
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding