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(Hypertension. 2008;52:1014.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Brain Indices Predict Blood Pressure Control

Aging Brains and New Predictions

Merrill F. Elias; Gregory A. Dore

From the Graduate School of Biomedical Sciences (M.F.E.) and Department of Psychology (G.A.D., M.F.E.), University of Maine, Orono.

Correspondence to Merrill F. Elias, Department of Psychology, 5742 Little Hall, University of Maine, Orono, ME 04669-5724. E-mail MFElias@AOL.com

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Hypertension is a predictor of dementia and is associated with subtle deficits in cognitive performance in stroke- and dementia-free individuals.¹ Younger hypertensive individuals may be as vulnerable to subtle progressive decline in cognitive ability as older individuals, although the pathophysiological mechanisms involved may be different.^1,2 Hypertension-associated structural and functional changes in the brain begin at a surprisingly early age, and this has led to an increasing emphasis on the importance of early diagnosis and treatment.² The study by Jennings et al³ in this issue of Hypertension provides further support for diagnosis and treatment as early as possible in the course of hypertension. Moreover, it offers a reasonable approach to examining the efficacy of various antihypertensive classes or agents in normalizing blood pressure.

The Jennings group related indices of "brain aging" to the success of lowering blood pressure (BP) in 45 relatively healthy individuals with idiopathic hypertension and no previous history of antihypertensive medication. After structural MRI and functional position emission tomography, participants were randomly assigned in a double-blind procedure to treatment with either lisinopril (n=21), an angiotensin converting enzyme inhibitor (ACE-I), or atenolol (n=24), a β-blocking agent (β-blocker). Systolic and diastolic BPs after 1 year of treatment were related to pretreatment indices of brain aging consisting of combined ratings of ventricle and sulcal size and white matter hyperintensities and pretreatment change in regional cerebral blood flow (rCBF) in the thalamus in response to a working memory task. Together, the structural brain index and blood flow response predicted 20% of the . . . [Full Text of this Article]

Related Article:

Brain Imaging Findings Predict Blood Pressure Response to Pharmacological Treatment

J. Richard Jennings, Matthew F. Muldoon, Ellen M. Whyte, Joelle Scanlon, Julie Price, and Carolyn C. Meltzer
Hypertension 2008 52: 1113-1119. [Abstract] [Full Text] [PDF]