Relationship of hypertension, blood pressure, and blood pressure control with white matter abnormalities in the Women's Health Initiative Memory Study (WHIMS)-MRI trial

Lewis H Kuller; Karen L Margolis; Sarah A Gaussoin; Nick R Bryan; Diana Kerwin; Marian Limacher; Sylvia Wassertheil-Smoller; Jeff Williamson; Jennifer G Robinson; Women's Health Initiative Memory Study Research Group

doi:10.1111/j.1751-7176.2009.00234.x

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Relationship of hypertension, blood pressure, and blood pressure control with white matter abnormalities in the Women's Health Initiative Memory Study (WHIMS)-MRI trial

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Relationship of hypertension, blood pressure, and blood pressure control with white matter abnormalities in the Women's Health Initiative Memory Study (WHIMS)-MRI trial

Lewis H Kuller, Karen L Margolis, Sarah A Gaussoin, Nick R Bryan, Diana Kerwin, Marian Limacher, Sylvia Wassertheil-Smoller, Jeff Williamson, Jennifer G Robinson and Women's Health Initiative Memory Study Research Group

The journal of clinical hypertension (Greenwich, Conn.), Vol.12(3), pp.203-212

03/2010

DOI: 10.1111/j.1751-7176.2009.00234.x

PMCID: PMC2864933

PMID: 20433539

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Abstract

This paper evaluates the relationship of blood pressure (BP) levels at Women's Health Initiative (WHI) baseline, treatment of hypertension, and white matter abnormalities among women in conjugated equine estrogen (CEE) and medroxyprogesterone acetate and CEE-alone arms. The WHI Memory Study-Magnetic Resonance Imaging (WHIMS-MRI) trial scanned 1424 participants. BP levels at baseline were significantly positively related to abnormal white matter lesion (WML) volumes. Participants treated for hypertension but who had BP > or = 140/90 mm Hg had the greatest amount of WML volumes. Women with untreated BP > or = 140/90 mm Hg had intermediate WML volumes. Abnormal WML volumes were related to hypertension in most areas of the brain and were greater in the frontal lobe than in the occipital, parietal, or temporal lobes. Level of BP at baseline was strongly related to amount of WML volumes. The results of the study reinforce the relationship of hypertension and BP control and white matter abnormalities in the brain. The evidence to date supports tight control of BP levels, especially beginning at younger and middle age as a possible and perhaps only way to prevent dementia.

Estrogen Replacement Therapy

Memory - drug effects

Age Factors

Follow-Up Studies

United States

Humans

Medroxyprogesterone Acetate - therapeutic use

Hypertension - drug therapy

Antihypertensive Agents - therapeutic use

Hypertensive Encephalopathy - diagnosis

Randomized Controlled Trials as Topic

Estrogens, Conjugated (USP) - therapeutic use

Magnetic Resonance Imaging

Multicenter Studies as Topic

Image Processing, Computer-Assisted

Brain - pathology

Mental Status Schedule

Female

Aged

Blood Pressure - drug effects

Drug Therapy, Combination

Hypertension - diagnosis

Details

Title: Subtitle: Relationship of hypertension, blood pressure, and blood pressure control with white matter abnormalities in the Women's Health Initiative Memory Study (WHIMS)-MRI trial
Creators: Lewis H Kuller - Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA 15213, USA. kullerl@edc.pitt.edu
Karen L Margolis
Sarah A Gaussoin
Nick R Bryan
Diana Kerwin
Marian Limacher
Sylvia Wassertheil-Smoller
Jeff Williamson
Jennifer G Robinson
Women's Health Initiative Memory Study Research Group
Resource Type: Journal article
Publication Details: The journal of clinical hypertension (Greenwich, Conn.), Vol.12(3), pp.203-212
DOI: 10.1111/j.1751-7176.2009.00234.x
PMID: 20433539
PMCID: PMC2864933
NLM abbreviation: J Clin Hypertens (Greenwich)
ISSN: 1751-7176
eISSN: 1751-7176
Publisher: United States
Grant note: N01 WH032112 / WHI NIH HHS 24152 / PHS HHS 32108-9 / PHS HHS 32105-6 / PHS HHS 32122 / PHS HHS 32111-13 / PHS HHS 32115 / PHS HHS 42129-32 / PHS HHS 44221 / PHS HHS 32100-2 / PHS HHS 42107-26 / PHS HHS 32118-32119 / PHS HHS N01WH22110 / WHI NIH HHS
Language: English
Date published: 03/2010
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983996074602771

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