PDF(Pubmed)
Abstract：
Adults with Down syndrome are less likely to have hypertension than neurotypical adults. However, whether blood pressure measures are associated with brain health and clinical outcomes in this population has not been studied in detail. Here, we assessed whether pulse pressure is associated with markers of cerebrovascular disease and is linked to a diagnosis of dementia in adults with Down syndrome via structural imaging markers of cerebrovascular disease and atrophy. The study included participants with Down syndrome from the Alzheimer\'s Disease - Down Syndrome study (n = 195, age = 50.6 ± 7.2 years, 44% women, 18% diagnosed with dementia). Higher pulse pressure was associated with greater global, parietal and occipital white matter hyperintensity volume but not with enlarged perivascular spaces, microbleeds or infarcts. Using a structural equation model, we found that pulse pressure was associated with greater white matter hyperintensity volume, which in turn was related to increased neurodegeneration, and subsequent dementia diagnosis. Pulse pressure is an important determinant of brain health and clinical outcomes in individuals with Down syndrome despite the low likelihood of frank hypertension.
摘要：
患有唐氏综合症的成年人比神经典型的成年人患高血压的可能性较小。然而,尚未详细研究该人群的血压测量值是否与大脑健康和临床结局相关.这里,我们评估了脉压是否与脑血管疾病标志物相关,并通过脑血管疾病和萎缩的结构成像标志物与唐氏综合征成人痴呆的诊断相关.该研究包括来自阿尔茨海默病-唐氏综合症研究的唐氏综合症参与者（n=195，年龄=50.6±7.2岁，44%的女性，18%被诊断为痴呆症)。更高的脉压与更大的全球相关，顶叶和枕骨白质高强度体积，但不伴有血管周围间隙增大，微出血或梗塞。使用结构方程模型，我们发现脉压与更大的白质高强度容积有关,这反过来又与神经变性增加有关，以及随后的痴呆症诊断。脉压是唐氏综合征患者脑健康和临床结果的重要决定因素，尽管发生高血压的可能性很低。
