Evidence map›Paper›PMID 28663254›Full record

ArticleArteriosclerosis, thrombosis, and vascular biology2017

Blood Pressure and Heart Rate Measures Associated With Increased Risk of Covert Brain Infarction and Worsening Leukoaraiosis in Older Adults.

Lester Y Leung, Traci M Bartz, Kenneth Rice, James Floyd, Bruce Psaty, Jose Gutierrez, W T Longstreth, Kenneth J Mukamal

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Arteriosclerosis, thrombosis, and vascular biology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.

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  4. Weight change, variability, and trajectories and risk of hip fracture among older adults with dysglycemia: the cardiovascular health study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Lester Y LeungFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.). lester.y.leung.md@gmail.com.
Traci M BartzFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
Kenneth RiceFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
James FloydFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
Bruce PsatyFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
Jose GutierrezFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
W T LongstrethFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
Kenneth J MukamalFrom the Division of Stroke and Cerebrovascular Diseases, Department of Neurology, Tufts Medical Center, Boston, MA (L.Y.L.); Department of Biostatistics (T.M.B., K.R.), Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology (J.F.), Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (B.P.), and Departments of Neurology and Epidemiology (W.T.L.), University of Washington, Seattle; Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.P.); Division of Stroke and Cerebrovascular Disease, Department of Neurology, Columbia University Medical Center, New York City, NY (J.G.); and Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.).
Beth Israel Deaconess Medical Center · USColumbia University Irving Medical Center · USKaiser Permanente Washington Health Research Institute · US

Funding

Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CHS research resources for the cardiovascular health of older adultsU01HL130114 · NHLBI · UNIVERSITY OF WASHINGTON · PI BURKE, GREGORY L, KRONMAL, RICHARD A · 2016 to 2019
$6.6M
CHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6M
Role of EIIIA fibronectin in pulmonary fibrosisR01HL085083 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WHITE, ERIC S · 2007 to 2011
$1.9M
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · HC · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1988 to 2000
–
CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · HC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KULLER, LEWIS H · 1988 to 2000
–
MRI READING CENTER FOR THE CARDIOVASCULAR HEALTH STUDYN01HC015103 · HC · JOHNS HOPKINS UNIVERSITY · PI BEAUCHAMP, NORMAN J · 1991 to 1998
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CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1988 to 2000
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085083 · HC · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1988 to 1999
–
CHS-Transition Phase -268055222-268055222N01HC055222 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 2005 to 2006
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CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · HC · UNIVERSITY OF WASHINGTON · 1988 to 2005
–
CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1988 to 2000
–
NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC015103NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS U01 HL080295NHLBI NIH HHS U01 HL130114NIA NIH HHS R01 AG023629
6 · The paper itself

Abstract

objectiveIn people without previous stroke, covert findings on serial magnetic resonance imaging (MRI) of incident brain infarcts and worsening leukoaraiosis are associated with increased risk for ischemic stroke and dementia. We evaluated whether various measures of blood pressure (BP) and heart rate are associated with these MRI findings. APPROACH AND

resultsIn the CHS (Cardiovascular Health Study), a longitudinal cohort study of older adults, we used relative risk regression to assess the associations of mean, variability, and trend in systolic BP, diastolic BP, and heart rate measured at 4 annual clinic visits between 2 brain MRIs with incident covert brain infarction and worsening white matter grade (using a 10-point scale to characterize leukoaraiosis). We included participants who had both brain MRIs, no stroke before the follow-up MRI, and no change in antihypertensive medication status during follow-up. Among 878 eligible participants, incident covert brain infarction occurred in 15% and worsening white matter grade in 27%. Mean systolic BP was associated with increased risk for incident covert brain infarction (relative risk per 10 mm Hg, 1.28; 95% confidence interval, 1.12-1.47), and mean diastolic BP was associated with increased risk for worsening white matter grade (relative risk per 10 mm Hg, 1.45; 95% confidence interval, 1.24-1.69). These findings persisted in secondary and sensitivity analyses.

conclusionsElevated mean systolic BP is associated with increased risk for covert brain infarction, and elevated mean diastolic BP is associated with increased risk for worsening leukoaraiosis. These findings reinforce the importance of hypertension in the development of silent cerebrovascular diseases, but the pathophysiologic relationships to BP for each may differ.

Indexed as

Blood PressureHeart RateAgedAge FactorsAntihypertensive AgentsCerebral InfarctionDisease ProgressionFemaleHumansHypertensionIncidenceLeukoaraiosisLongitudinal StudiesMagnetic Resonance ImagingMaleProspective StudiesAntihypertensive Agentsblood pressureheart ratehypertensionleukoaraiosisrisk factors

Identifiers

PMID28663254
PMCPMC5551454
OpenAlexW2730170709

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.