cqvip:Objective: To determine the potential role of whole brain atrophy, hippocampa l atrophy, or both, and small vessel disease/white matter lesions as mechanisms underlying the cognitive impairment associated with hypertension. Methods: Using MRI scanning the authors determined hippocampal volumes, whole brain volumes, a nd location and severity of white matter lesions, using Scheltens scale, in 103 hypertensive (166 ± 8/88 ± 7 mm Hg, 54 female) and 51 normotensive (132 ± 12/ 74 ± 7 mm Hg, 21 female) subjects age ≥ 70 years. Results: Compared to normote nsive subjects, older hypertensive subjects had significantly smaller whole brai n volumes (887 ± 109 vs 930 ± 97 cm3, p = 0.02) and nonsignificantly reduced h ippocampal volumes (5.39 ± 1.60 vs 5.67 ± 1.80 cm 3, p = 0.33). Hypertensive s ubjects had an increased burden of periventricular lesions: bands (p = 0.03), fr ontal caps (p = 0.08), occipital caps (p = 0.07), and total periventricular hype rintensities (p = 0.02). They also had higher scores in subcortical areas: front al (p = 0.04), temporal (p = 0.03), and deep white matter areas (p = 0.05). A co rrelation was found between whole brain volumes and systolic blood pressure (r = - 0.19, p = 0.02). No correlation was seen between whole brain volumes and whi te matter lesion burden. Conclusions: Moderate hypertension in non-impaired ol der subjects is associated with smaller whole brain volume and an increased burd en of subcortical and periventricular white matter lesions.
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