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Pulse Pressure, White Matter Hyperintensities, and Cognition: Mediating Effects Across the Adult Lifespan
Jade Hannan, Sarah E. Newman-Norlund, Natalie Busby, Sarah C. Wilson, Roger Newman‐Norlund, Chris Rorden, Julius Fridriksson, Leonardo Bonilha et al.. Annals of Clinical and Translational Neurology, 2025-05-25
Topic: Risk, prevention and care in population studies
Pulse pressure, but not mean arterial pressure, significantly mediated the relationship between age and white matter hyperintensity load. White matter hyperintensity load partially mediated the relationship between age and Montreal Cognitive Assessment score. Our results indicate that pulse pressure, but not mean arterial pressure, is mechanistically associated with age-related accumulation of white matter hyperintensities, independent of other cardiovascular risk factors. White matter hyperintensity load was a mediator of cognitive scores across the adult lifespan. Effective management of pulse pressure may be especially important for maintenance of brain health and cognition.
Key findings
- Pulse pressure, but not mean arterial pressure, significantly mediated the relationship between age and white matter hyperintensity load.
- White matter hyperintensity load partially mediated the relationship between age and Montreal Cognitive Assessment score.
- Our results indicate that pulse pressure, but not mean arterial pressure, is mechanistically associated with age-related accumulation of white matter hyperintensities, independent of other cardiovascular risk factors.
- White matter hyperintensity load was a mediator of cognitive scores across the adult lifespan.
- Effective management of pulse pressure may be especially important for maintenance of brain health and cognition.
Why it matters
Pulse pressure, but not mean arterial pressure, was linked to white matter hyperintensity load, which in turn was linked to lower cognitive scores across adulthood. The authors suggest that managing pulse pressure may help maintain brain health, but this is an observational finding and not a tested treatment.
Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 46/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Annals of Clinical and Translational Neurology) |
| Journal's citation record | 1 / 4 | Annals of Clinical and Translational Neurology: journal h-index 97 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| 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 | 2 / 7 | Cited 7 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 7 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Nicholas Riccardi: h-index 13 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of South Carolina: institution h-index 712 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40413732) |
| Free to read | 2 / 2 | Free to read |
| Total | 46 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1002/acn3.70086
- PubMed: 40413732
- Original source →
- Free full text: Annals of Clinical and Translational Neurology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Hannan, J., Newman-Norlund, S. E., Busby, N., Wilson, S. C., Newman‐Norlund, R., Rorden, C., et al. (2025). Pulse Pressure, White Matter Hyperintensities, and Cognition: Mediating Effects Across the Adult Lifespan. Annals of Clinical and Translational Neurology. https://doi.org/10.1002/acn3.70086
Vancouver
Hannan J, Newman-Norlund SE, Busby N, Wilson SC, Newman‐Norlund R, Rorden C, et al. Pulse Pressure, White Matter Hyperintensities, and Cognition: Mediating Effects Across the Adult Lifespan. Annals of Clinical and Translational Neurology. 2025. doi:10.1002/acn3.70086. PMID: 40413732.
BibTeX
@article{hannan2025-40413732,
author = {Hannan, Jade and Newman-Norlund, Sarah E. and Busby, Natalie and Wilson, Sarah C. and Newman‐Norlund, Roger and Rorden, Chris and Fridriksson, Julius and Bonilha, Leonardo and others},
title = {{Pulse Pressure, White Matter Hyperintensities, and Cognition: Mediating Effects Across the Adult Lifespan}},
journal = {Annals of Clinical and Translational Neurology},
year = {2025},
doi = {10.1002/acn3.70086},
pmid = {40413732},
url = {https://doi.org/10.1002/acn3.70086}
}
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