ReviewAmerican journal of physiology. Heart and circulatory physiology2018
Impact of pulse pressure on cerebrovascular events leading to age-related cognitive decline.
Review in American journal of physiology. Heart and circulatory physiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 89 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
89 citing papers in PubMed, 2 syntheses or guidelines pooled it, 143 citations in OpenAlex.
- Association Between Pulse Pressure and Structural Brain Changes in Aging: A Systematic Review and Meta-Analysis of Cross-Sectional and Longitudinal Studies.Journal of the American Heart Association · 2025Pooled it
- Arterial stiffness measured by pulse wave velocity correlated with cognitive decline in hypertensive individuals: a systematic review.BMC neurology · 2024Pooled it
- Exercise Training Reduces Cerebrovascular Impedance in Patients with Amnestic Mild Cognitive Impairment: A 1-Year Randomized Controlled Trial.Medicine and science in sports and exercise · 2026Trial
- One-year aerobic exercise increases cerebral blood flow in cognitively normal older adults.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023Trial
- Aerobic exercise training reduces cerebrovascular impedance in older adults: a 1-year randomized controlled trial.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Trial
- Cerebral amyloid associated with global cognition is differentially moderated by pulse pressure across education levels in The 90+ Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Attenuated aortic-cerebral pulsatile transmission with posture-related increases in stroke volume in healthy young adults.European journal of applied physiology · 2026Article
- Systemic proportional pulse index is associated with incident probable dementia: aJournal of geriatric neurology · 2026Article
- Molecular pathways linking traumatic brain injury to cardiovascular dysfunction: therapeutic potential of physical exercise.Metabolic brain disease · 2026Review
- Age-related arterial stiffness and cerebrovascular dysfunction in mice correlate with cognitive impairment but are not reduced with long-term ALT-711 treatment.Physiological reports · 2026Article
- Associations among dynamic cerebral autoregulation, baroreflex sensitivity, and carotid distensibility in young healthy adults: insight from endurance training.European journal of applied physiology · 2026Article
- Altered cerebrovascular haemodynamics in Parkinson's disease: Insights from 4D flow MRI.NPJ Parkinson's disease · 2026Article
- Impact of Intraprocedural Pulse Pressure During Mechanical Thrombectomy on Functional and Radiological Outcomes in Patients with Acute Ischemic Stroke.Medical sciences (Basel, Switzerland) · 2026Article
- Cerebral blood flow regulation, central arterial stiffness and traumatic brain injury: Effects of aerobic exercise training.Experimental physiology · 2026Review
- Longitudinal sex differences in cerebrovascular ageing in older adults: results from the brain in motion study.The Journal of physiology · 2026Article
- Article
- Differential Left and Right Carotid Artery Blood Flow and Altered Hippocampal Mitochondrial Function After Transverse Aortic Constriction in Aging Rats.Journal of the American Heart Association · 2026Article
- From stress to cognitive impairment: an integrative model of oxidative and hemorheological mechanisms.Dementia & neuropsychologia · 2026Review
- The impact of age and sex on cerebral and large artery stiffness and the response to pulse pressure.American journal of physiology. Heart and circulatory physiology · 2025Article
- Association between cumulative blood pressure and the risk of cognitive impairment in Chinese older adults: a longitudinal study over 16 years.BMC geriatrics · 2025Article
29 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aging is a modern concept: human life expectancy has more than doubled in less than 150 yr in Western countries. Longer life span, however, reveals age-related diseases, including cerebrovascular diseases. The vascular system is a prime target of aging: the "wear and tear" of large elastic arteries exposed to a lifelong pulsatile pressure causes arterial stiffening by fragmentation of elastin fibers and replacement by stiffer collagen. This arterial stiffening increases in return the amplitude of the pulse pressure (PP), its wave penetrating deeper into the microcirculation of low-resistance, high-flow organs such as the brain. Several studies have associated peripheral arterial stiffness responsible for the sustained increase in PP, with brain microvascular diseases such as cerebral small vessel disease, cortical gray matter thinning, white matter atrophy, and cognitive dysfunction in older individuals and prematurely in hypertensive and diabetic patients. The rarefaction of white matter is also associated with middle cerebral artery pulsatility that is strongly dependent on PP and artery stiffness. PP and brain damage are likely associated, but the sequence of mechanistic events has not been established. Elevated PP promotes endothelial dysfunction that may slowly develop in parallel with the accumulation of proinflammatory senescent cells and oxidative stress, generating cerebrovascular damage and remodeling, as well as brain structural changes. Here, we review data suggesting that age-related increased peripheral artery stiffness may promote the penetration of a high PP to cerebral microvessels, likely causing functional, structural, metabolic, and hemodynamic alterations that could ultimately promote neuronal dysfunction and cognitive decline.
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Registered trials
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.