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@ARTICLE{Gronewold:902561,
      author       = {Gronewold, J. and Jokisch, M. and Schramm, S. and Jockwitz,
                      Christiane and Miller, Tatiana and Lehmann, N. and Moebus,
                      S. and Jöckel, K. H. and Caspers, Svenja and Hermann, D.
                      M.},
      title        = {{A}ssociation of blood pressure, its treatment, and
                      treatment efficacy with volume of white matter
                      hyperintensities in the population-based 1000{BRAINS}
                      {S}tudy},
      journal      = {Hypertension},
      volume       = {78},
      number       = {5},
      issn         = {0194-911X},
      address      = {Baltimore, Md.},
      publisher    = {Williams $\&$ Wilkins},
      reportid     = {FZJ-2021-04360},
      pages        = {1490-1501},
      year         = {2021},
      abstract     = {White matter hyperintensities (WMHs) of presumed vascular
                      origin are a frequent finding in cerebral magnetic resonance
                      imaging of older people. They are attributed to small vessel
                      disease and involved in the pathogenesis of cognitive
                      decline. Since vascular risk factors, especially arterial
                      hypertension, predispose to small vessel disease, we
                      analyzed the association of systolic blood pressure (SBP),
                      diastolic blood pressure (DBP), and antihypertensive
                      medications with WMH volume in 560 participants of the
                      1000BRAINS study, drawn from the population-based Heinz
                      Nixdorf Recall study (65.2±7.5 years; $51.4\%$ men).
                      Further, we analyzed treatment efficacy using a
                      classification of 6 BP treatment groups defined by
                      antihypertensive medication and level of BP: (1) untreated
                      BP <120/<80 mm Hg, (2) untreated SBP 120 to 139 or DBP 80
                      to 89 mm Hg, (3) untreated BP ≥140 or ≥90 mm Hg, (4)
                      treated BP <120/<80 mm Hg, (5) treated SBP 120 to 139 or
                      DBP 80 to 89 mm Hg, and (6) treated BP ≥140 or ≥90
                      mm Hg. Median WMH volume (Q1–Q3) was 4.6 (3.0–7.8)
                      cm3; mean±SD of SBP and DBP was 128.6±17.4 and 76.1±9.8
                      mm Hg. In multivariable linear regression models,
                      continuous SBP (β=0.63 cm3 per 10 mm Hg $[95\%$ CI,
                      0.32–0.94]), DBP (0.64 cm3 per 5 mmHg $[95\%$ CI,
                      0.37–0.91]), and antihypertensive treatment (1.23 cm3
                      $[95\%$ CI, 0.14–2.23]) were significantly associated with
                      WMH volume. Regarding treatment efficacy, only participants
                      with hypertension despite treatment (treated BP ≥140 or
                      ≥90 mm Hg) had significantly increased WMH volume (4.24
                      cm3 [2.36–6.13]) compared with normotension without
                      treatment (untreated BP <120/<80 mm Hg). Our results
                      suggest that WMHs represent a marker of advanced
                      hypertension pathology. Hence, early treatment should
                      prevent WMHs.},
      cin          = {INM-1},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-1-20090406},
      pnm          = {5251 - Multilevel Brain Organization and Variability
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5251},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34628935},
      UT           = {WOS:000707194400040},
      doi          = {10.1161/HYPERTENSIONAHA.121.18135},
      url          = {https://juser.fz-juelich.de/record/902561},
}