Most Read Articles
Kathlin Ambrose, 12 Nov 2015
The outcome for patients experiencing out-of-hospital sudden cardiac arrest (OSCA) remains very poor in Malaysia. Local data shows that return of spontaneous circulation in OSCA patients stands at 17.4 percent, while survival to ward is a mere 4.3 percent. [Med J Malaysia 2008; 63:4–8]
Tristan Manalac, 3 days ago
Contrary to conventional knowledge, consumption of dairy products appears to reduce the risk of major cardiovascular disease events and mortality, according to a recent multinational study.
Pearl Toh, 17 Sep 2018
Lifestyle interventions incorporating diet and exercise slash the need for antihypertensive medications by more than half among overweight or obese adults with high blood pressure (BP), according to a secondary analysis of the ENCORE trial presented at the Joint Hypertension 2018 Scientific Sessions.
Christina Lau, 31 Aug 2018

Daily low-dose aspirin is not beneficial for primary prevention of cardiovascular (CV) events in patients with diabetes or moderate CV risk, according to results of the ASCNED and ARRIVE trials reported at the European Society of Cardiology (ESC) Congress 2018.

Diastolic BP associated with biomarkers of cerebrovascular, Alzheimer’s disease

08 Aug 2017

Diastolic blood pressure (BP) shows utility as a predictor of cerebrovascular disease and Alzheimer’s disease (AD) pathology, such that increased diastolic BP is associated with increased white matter hyperintensities (WMHs) and reduced hippocampal volume, according to a study.

The study included 227 members of the 1936 Birth Cohort. BP was measured biennially between 64 and 68 years, while brain magnetic resonance imaging (MRI) was performed at 68 years. Outcomes investigated included WMH abundance and hippocampal volume, whereas risk factors of interest were diastolic and systolic BP and their visit-to-visit variability.

In regression models, higher diastolic BP predicted increased WMH (p=0.044) and smaller hippocampi (p=0.006), with diastolic BP variability linked to lower hippocampal volume (p=0.033). On the other hand, higher systolic BP predicted larger hippocampi (p=0.013).

The observed relationships were independent of confounding life-course risk factors. Moreover, BP-lowering medication, which did not modify the relationships, was independently associated with increased WMH (p=0.011).

Researchers noted that the present data offer insight into the complex and differing relationships between BP components and brain pathology, and may explain the heterogeneous relationships between BP and cognition reported in previous studies.

“Treating systolic hypertension may have the consequence of accelerating hippocampal atrophy, whereas treating diastolic hypertension and reducing its long-term variability could ameliorate hippocampal atrophy and cerebrovascular disease, both risk factors for dementia,” they said, adding that targeting diastolic hypertension should be a primary goal for reducing neurodegeneration in older age.

Common in older age, hypertension has been shown to be associated with MRI markers of brain degeneration that accompany ageing and dementia. Cerebrovascular disease is visible on MRI scans as hyperintense regions known as WMHs, which are in turn associated with reduced cognitive performance and dementia. On the other hand, reduced hippocampal volume is a marker of hippocampal atrophy and is a useful indicator of AD pathology. [BMJ Open 2013;3:e003423; J Neurol Neurosurg Psychiatry 2007;78:1325–301; Neurobiol Aging 2010;31:378–86]

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Most Read Articles
Kathlin Ambrose, 12 Nov 2015
The outcome for patients experiencing out-of-hospital sudden cardiac arrest (OSCA) remains very poor in Malaysia. Local data shows that return of spontaneous circulation in OSCA patients stands at 17.4 percent, while survival to ward is a mere 4.3 percent. [Med J Malaysia 2008; 63:4–8]
Tristan Manalac, 3 days ago
Contrary to conventional knowledge, consumption of dairy products appears to reduce the risk of major cardiovascular disease events and mortality, according to a recent multinational study.
Pearl Toh, 17 Sep 2018
Lifestyle interventions incorporating diet and exercise slash the need for antihypertensive medications by more than half among overweight or obese adults with high blood pressure (BP), according to a secondary analysis of the ENCORE trial presented at the Joint Hypertension 2018 Scientific Sessions.
Christina Lau, 31 Aug 2018

Daily low-dose aspirin is not beneficial for primary prevention of cardiovascular (CV) events in patients with diabetes or moderate CV risk, according to results of the ASCNED and ARRIVE trials reported at the European Society of Cardiology (ESC) Congress 2018.