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59/100

✓ Peer-reviewed alzhub usefulness score 59 out of 100. Risk factors

Topic: Risk, prevention and care in population studies

Cerebral white matter lesions are frequently observed on magnetic resonance imaging (MRI) scans in elderly people and are associated with stroke and dementia. Elevated blood pressure is presumed one of the main risk factors, although data are almost exclusively derived from cross-sectional studies. We assessed in 10 European cohorts the relation between concurrently and previously measured blood pressure levels, hypertension, its treatment, and severe cerebral white matter lesions. In total, 1805 nondemented subjects aged 65 to 75 years were sampled from ongoing community-based studies that were initiated 5 to 20 years before the MRI. White matter lesions in the periventricular and subcortical region were rated separately using semiquantitative measures. We performed logistic regression analyses adjusted for potential confounders in 1625 people with complete data. Concurrently and formerly assessed diastolic and systolic blood pressure levels were positively associated with severe white matter lesions. Both increases and decreases in diastolic blood pressure were associated with more severe periventricular white matter lesions. Increase in systolic blood pressure levels was associated with more severe periventricular and subcortical white matter lesions. People with poorly controlled hypertension had a higher risk of severe white matter lesions than those without hypertension, or those with controlled or untreated hypertension. Higher blood pressure was associated with an increased risk of severe white matter lesions. Successful treatment of hypertension may reduce this risk; however, a potential negative effect of decreasing diastolic blood pressure level on the occurrence of severe periventricular white matter lesions should be taken into account.

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APA 7th

van Dijk, E. J., Breteler, M. M., Schmidt, R., Berger, K., Nilsson, L. G., Oudkerk, M., et al. (2004). The association between blood pressure, hypertension, and cerebral white matter lesions: cardiovascular determinants of dementia study. Hypertension (Dallas, Tex. : 1979). https://doi.org/10.1161/01.hyp.0000145857.98904.20

Vancouver

van Dijk EJ, Breteler MM, Schmidt R, Berger K, Nilsson LG, Oudkerk M, et al. The association between blood pressure, hypertension, and cerebral white matter lesions: cardiovascular determinants of dementia study. Hypertension (Dallas, Tex. : 1979). 2004. doi:10.1161/01.hyp.0000145857.98904.20. PMID: 15466662.

BibTeX

@article{vandijk2004-15466662,
  author  = {van Dijk, E. J. and Breteler, M. M. and Schmidt, R. and Berger, K. and Nilsson, L. G. and Oudkerk, M. and Pajak, A. and Sans, S. and others},
  title   = {{The association between blood pressure, hypertension, and cerebral white matter lesions: cardiovascular determinants of dementia study}},
  journal = {Hypertension (Dallas, Tex. : 1979)},
  year    = {2004},
  doi     = {10.1161/01.hyp.0000145857.98904.20},
  pmid    = {15466662},
  url     = {https://doi.org/10.1161/01.hyp.0000145857.98904.20}
}

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Key findings

Cerebral white matter lesions are frequently observed on magnetic resonance imaging (MRI) scans in elderly people and are associated with stroke and dementia.
Concurrently and formerly assessed diastolic and systolic blood pressure levels were positively associated with severe white matter lesions.
Both increases and decreases in diastolic blood pressure were associated with more severe periventricular white matter lesions.
Increase in systolic blood pressure levels was associated with more severe periventricular and subcortical white matter lesions.
People with poorly controlled hypertension had a higher risk of severe white matter lesions than those without hypertension, or those with controlled or untreated hypertension.

Why it matters

In 1,805 dementia-free people aged 65 to 75 from 10 European community studies, blood pressure measured both at the time of a brain MRI and 5 to 20 years earlier was associated with severe white matter lesions, a brain-scan finding the authors note is linked to stroke and dementia. People with poorly controlled hypertension had the highest risk, but falling as well as rising diastolic pressure was linked to more lesions near the brain's ventricles, so the authors caution that successful treatment "may reduce this risk" while lowering diastolic pressure could carry its own risk. The study measured brain lesions, not dementia, and it shows associations, not cause and effect.

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Study details

Study designcross-sectional
Participants1,625
Evidence strengthLow

How this study scored 59/100

Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Hypertension (Dallas, Tex. : 1979))
Journal's citation record	3 / 4	Hypertension: journal h-index 369 (OpenAlex, 2026-10-29)
Study design	4 / 12	A snapshot of people at one point in time
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	2004 — older than 20 years, still counted
Sample size	3 / 4	1,625 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 347 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	14.5 citations a year over 24 year(s) since 2004
Impact for its field and year	4 / 6	Cited 13.6× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	3 / 6	Cited by 14 other studies in this library
Still being cited	2 / 4	Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	4 / 4	Last-listed author Albert Hofman: h-index 207 (OpenAlex, whole career)
Institution's track record	1 / 3	University of Groningen: institution h-index 1,383 (OpenAlex)
Multicenter collaboration	2 / 3	OpenAlex lists 6 institution(s) in 4 countries
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 15466662)
Free to read	0 / 2	Behind a paywall — scores zero
Total	59 / 100	—

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