The long range goal of this project is to determine whether ambulatory blood pressure technology is useful in predicting early brain and cognitive changes that may predate stroke and other cerebrovascular pathology in healthy, elderly adults. The proposal attempts to relate 24-hour ambulatory blood pressure and heart rate to subtle brain damage assessed by magnetic resonance imaging (MRI) and associated changes. We will look at blood pressure and heart rate level and variability during two entire 24-hour periods, as well as during particular time periods or activities, e.g., morning versus other time periods, sleep versus waking, rest versus exercise, high versus low stress reported in diaries. The subjects will be 150 unmedicated men and women, between 55 and 80 years of age, with normotensive to elevated blood pressure levels. A complete medical exam will be given to exclude current disorders. Measurements will be taken of clinic blood pressure and heart rate. In addition, neuropsychological tests will sample such critical areas of cognitive functioning as memory, attention, and cognitive flexibility. We predict that, in comparison to standard clinic blood pressure measurements, ambulatory blood pressure (particularly during sleep) will be more indicate of cognitive deficits and MRI white matter and other brain changes, known as T2 hyperintensities. Normotensive and hypertensive elderly subjects with high sleeping blood pressure and heart rate values, very little decrease in ambulatory blood pressure and heart rate from waking to sleep, and large blood pressure and heart rate variability are expected to exhibit more problems with cognitive functioning and an increase in the number and severity of MRI T2 hyperintensities. If we find that elderly individuals with borderline to mild hypertension are at risk for cognitive deficit and brain damage, such results have clear implications for decisions regarding the appropriate level of blood pressure to treat in the elderly.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG011595-02
Application #
2052815
Study Section
Human Development and Aging Subcommittee 3 (HUD)
Project Start
1994-04-15
Project End
1997-03-31
Budget Start
1995-04-12
Budget End
1996-03-31
Support Year
2
Fiscal Year
1995
Total Cost
Indirect Cost
Name
University of California Los Angeles
Department
Psychiatry
Type
Schools of Medicine
DUNS #
119132785
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Goldstein, Iris B; Bartzokis, George; Guthrie, Donald et al. (2005) Ambulatory blood pressure and the brain: a 5-year follow-up. Neurology 64:1846-52
Goldstein, Iris B; Ancoli-Israel, Sonia; Shapiro, David (2004) Relationship between daytime sleepiness and blood pressure in healthy older adults. Am J Hypertens 17:787-92
Goldstein, Iris B; Shapiro, David; Guthrie, Donald (2003) A 5-year follow-up of ambulatory blood pressure in healthy older adults. Am J Hypertens 16:640-5
Goldstein, Iris B; Bartzokis, George; Guthrie, Donald et al. (2002) Ambulatory blood pressure and brain atrophy in the healthy elderly. Neurology 59:713-9
Bartzokis, G; Goldstein, I B; Hance, D B et al. (1999) The incidence of T2-weighted MR imaging signal abnormalities in the brain of cocaine-dependent patients is age-related and region-specific. AJNR Am J Neuroradiol 20:1628-35
Shapiro, D; Goldstein, I B (1998) Wrist actigraph measures of physical activity level and ambulatory blood pressure in healthy elderly persons. Psychophysiology 35:305-12
Goldstein, I B; Bartzokis, G; Hance, D B et al. (1998) Relationship between blood pressure and subcortical lesions in healthy elderly people. Stroke 29:765-72
Jaquet, F; Goldstein, I B; Shapiro, D (1998) Effects of age and gender on ambulatory blood pressure and heart rate. J Hum Hypertens 12:253-7