Hypertension, Vol 20, 340-348, Copyright © 1992 by American Heart Association
JA Salerno, DG Murphy, B Horwitz, C DeCarli, JV Haxby, SI Rapoport and MB Schapiro
To determine whether hypertension, the predominant risk factor for stroke
and vascular dementia, is associated with brain atrophy, magnetic resonance
imaging (MRI) scans were performed to quantify brain volumes and
cerebrospinal fluid spaces. Eighteen otherwise healthy, cognitively normal
older hypertensive men (mean +/- SD age, 69 +/- 8 years, duration of
hypertension 10-35 years) and 17 age-matched healthy, normotensive male
control subjects were studied in a cross- sectional design. Axial
proton-density image slices were analyzed using region-of-interest and
segmentation analyses. The hypertensive subjects had significantly larger
mean volumes of the right and left lateral ventricles (p less than 0.05,
both absolute volume and volume normalized to intracranial volume) and a
significantly smaller normalized mean left hemisphere brain volume (p less
than 0.05) with a trend toward significance for a smaller normalized mean
right hemisphere volume (p less than 0.09). Four hypertensive subjects and
one healthy control subject were found to have severe periventricular
hyperintensities on T2-weighted MRI images. When data for these subjects
were removed from the analyses, the normalized lateral ventricle volumes
remained significantly larger in the hypertensive group. Lateral ventricle
enlargement was not related to age or use of diuretics in the hypertensive
group nor to duration of hypertension between 10 and 24 years. Our findings
suggest that long-standing hypertension results in structural changes in
the brain. Longitudinal studies will determine whether MRI-associated
changes are progressive and if such changes identify hypertensive subjects
at increased risk for clinically apparent brain dysfunction.
ARTICLES
Brain atrophy in hypertension. A volumetric magnetic resonance imaging study
Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Bethesda, Md 20892.
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