Background: Although blood pressure variability (BPV) has emerged as a novel risk factor for Alzheimer's disease, few studies have examined the effects of night BPV on brain structure and function. This study investigated the association of night BPV with brain atrophy and cognitive function changes. Methods: The analysis included 1,398 participants with valid ambulatory blood pressure (BP) monitoring at baseline and both baseline and 4-year follow-up brain magnetic resonance images who were recruited from the Korean Genome and Epidemiology Study. Participants underwent a comprehensive neuropsychological test battery. BPV was derived from ambulatory BP monitoring and calculated as a standard deviation (SD) of 24-h and daytime and nighttime BP. Results: During the median follow-up of 4.3 years, increased SD of night systolic or diastolic BP was an indicator of total brain volume reduction, while daytime BPV or night average BP was not associated with total brain volume changes. High SD of night systolic BP was associated with reduced gray matter (GM) volume, independent of average night BP, and use of antihypertensive drugs. It also was associated with a reduction of temporal GM volume, mostly driven by atrophy in the left entorhinal cortex and the right fusiform gyrus. In cognitive performance, high variability of night systolic BP was associated with a decrease in visual delayed recall memory and verbal fluency for the category. Conclusion: Increased night BPV, rather than night mean BP, was associated with reduced brain volume and cognitive decline. High night BPV could be an independent predictor for rapid brain aging in a middle-aged population.
Bibliographical noteFunding Information:
This work was supported by funds (2011-E71004-00, 2012-E71005-00, 2013-E71005-00, 2014-E71003-00, 2015-P71001-00, 2016-E71003-00, 2017-E71001-00, and 2018-E71001-00) from the Korean Centers for Disease Control and Prevention, the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (2019M3E5D3073102, 2019R1H1A2039682, and 2020R1F1A1074265), a Korea University grant (K1824431 and K1810951), Ansan-Si hidden champion fostering and supporting project funded by Ansan city, and computational resources provided by the University of Iowa, Iowa City, Iowa.
Copyright © 2022 Yu, Kim, Park, Lee, Cho, Kim, Yoo, Seo, Kim, Kim, Choi, Baik, Shin and Kim.
- brain atrophy
- gray matter
- night blood pressure
ASJC Scopus subject areas
- Clinical Neurology