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Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe
den Heijer T, Launer LJ, Prins ND, van Dijk EJ, Vermeer SE, Hofman A, Koudstaal PJ, Breteler MM.. Neurology, 2005-01-01
Topic: Brain proteins, microglia and lab models
Background Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear. High blood pressure levels may cause cerebral small-vessel pathology, which contributes to cognitive decline in patients with AD. Alternatively, in persons with high blood pressure, increased numbers of neurofibrillary tangles and amyloid plaques at autopsy have also been observed, suggesting direct links between blood pressure and AD. Objective To investigate the association of blood pressure and markers of small-vessel disease (white matter lesions [WMLs] on MRI) with hippocampal and amygdalar atrophy on MRI-potential in vivo indicators of Alzheimer pathology. Methods In 1995 to 1996, 511 nondemented elderly subjects (age 60 to 90) underwent MRI. The extent of WMLs was assessed, and volumes of the hippocampus and amygdala were measured. Blood pressure levels were assessed at the time of MRI and 5 years before the MRI. Results Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase -0.10 mL [95% CI -0.19 to -0.02, p = 0.02]). Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy. Persons with more WMLs on MRI more often had severe atrophy of the hippocampus and amygdala. Conclusion Blood pressure and indicators of small-vessel disease in the brain may be associated with atrophy of structures affected by Alzheimer pathology.
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APA 7th
den Heijer, T., Launer, L. J., Prins, N. D., van Dijk, E. J., Vermeer, S. E., Hofman, A., et al. (2005). Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. Neurology. https://doi.org/10.1212/01.wnl.0000149641.55751.2e
Vancouver
den Heijer T, Launer LJ, Prins ND, van Dijk EJ, Vermeer SE, Hofman A, et al. Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe. Neurology. 2005. doi:10.1212/01.wnl.0000149641.55751.2e. PMID: 15668423.
BibTeX
@article{denheijer2005-15668423,
author = {den Heijer, T. and Launer, L. J. and Prins, N. D. and van Dijk, E. J. and Vermeer, S. E. and Hofman, A. and Koudstaal, P. J. and Breteler, M. M.},
title = {{Association between blood pressure, white matter lesions, and atrophy of the medial temporal lobe}},
journal = {Neurology},
year = {2005},
doi = {10.1212/01.wnl.0000149641.55751.2e},
pmid = {15668423},
url = {https://doi.org/10.1212/01.wnl.0000149641.55751.2e}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Background Blood pressure level is associated with the risk of clinical Alzheimer disease (AD), yet the underlying mechanisms are unclear.
- Results Higher diastolic blood pressure 5 years before MRI predicted more hippocampal atrophy in persons untreated for hypertension (per SD increase -0.10 mL [95% CI -0.19 to -0.02, p = 0.02]).
- Conversely, in persons treated for hypertension, a low diastolic blood pressure was associated with more severe atrophy.
- Conclusion Blood pressure and indicators of small-vessel disease in the brain may be associated with atrophy of structures affected by Alzheimer pathology.
Why it matters
In 511 older adults without dementia, higher diastolic blood pressure five years before an MRI scan went with a smaller hippocampus in people not treated for hypertension, while in people already on treatment it was *low* diastolic pressure that went with more atrophy. People with more white matter lesions also more often had severe shrinkage of the hippocampus and amygdala. This observational study shows associations only — the authors say blood pressure and small-vessel disease "may be associated" with atrophy in areas affected by Alzheimer pathology — and it did not test any treatment.
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Study details
- Evidence strengthLow
How this study scored 50/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 237 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.3 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 3 / 6 | Cited 7.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 10 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Monique M.B. Breteler: h-index 162 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15668423) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 50 / 100 | — |
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