Predicting White Matter Integrity: Pulse Pressure vs. Arterial Stiffness

Published on June 21, 2022

Imagine you’re driving on a curvy road with no streetlights. To ensure a safe journey, you need to understand the condition of the road. In a similar way, scientists are investigating how the stiffness of our arteries and the pressure of our blood pulses can affect the health of our brains. A recent study looked at over 17,000 participants from the UK Biobank to explore the relationship between pulse pressure (PP), arterial stiffness index (ASI), and white matter integrity in the brain. White matter integrity is essential for healthy brain function, acting like the smooth pavement on that curvy road. The study found that peripheral PP was a better predictor of white matter integrity than ASI, except for individuals over 75 years old. Surprisingly, after this age, neither PP nor ASI showed a significant relationship with white matter integrity. These findings raise important questions about the connection between arterial stiffness, blood pressure, and damage to white matter as we age. To delve deeper into this fascinating research and its potential impact on understanding dementia and Alzheimer’s disease, venture forth and explore the full article.

BackgroundAlzheimer’s disease and dementia in general constitute one of the major public health problems of the 21st century. Research in arterial stiffness and pulse pressure (PP) play an important role in the quest to reduce the risk of developing dementia through controlling modifiable risk factors.ObjectiveThe aim of the study is to investigate the association between peripheral PP, arterial stiffness index (ASI) and brain integrity, and to discover if ASI is a better predictor of white matter integrity than peripheral PP.Materials and Methods17,984 participants 63.09 ± 7.31 from the UK Biobank were used for this study. ASI was estimated using infrared light (photoplethysmography) and peripheral PP was calculated by subtracting the diastolic from the systolic brachial blood pressure value. Measure of fractional anisotropy (FA) was obtained from diffusion imaging to estimate white matter microstructural integrity. White matter hyperintensities were segmented from the combined T1 and T2-weighted FLAIR images as a measure of irreversible white matter damage.ResultsAn important finding is that peripheral PP better predicts white matter integrity when compared to ASI. This finding is consistent until 75 years old. Interestingly, no significant relationship is found between either peripheral PP or ASI and white matter integrity after 75 years old.ConclusionThese results suggest that ASI from plethysmography should not be used to estimate cerebrovascular integrity in older adults and further question the relationship between arterial stiffness, blood pressure, and white matter damage after the age of 75 years old.

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