Association Between Pulse Pressure and Structural Brain Changes in Aging: A Systematic Review and Meta-Analysis of Cross-Sectional and Longitudinal Studies
Abstract
Background: The aim of this study was to investigate the associations between pulse pressure (PP) and age-related structural brain changes including brain volumes, white matter hyperintensities (WMH), fractional anisotropy, silent brain lesions, microbleeds, cerebral blood flow and metabolism, and beta-amyloid accumulation.
Methods: Systematic review of PubMed (MEDLINE), Scopus, and Ovid Embase (from inception to January 2023) and references of included studies among adult populations was conducted. Findings were summarized narratively and by performing a fixed-effects meta-analysis. Publication bias was tested by a funnel plot and Egger's regression asymmetry test.
Results: Forty-seven studies (7 longitudinal) were included (>20 000 participants). In cross-sectional studies, PP consistently positively associated with gray matter volume and white matter hyperintensities with pooled standardized regression coefficients of 0.02 (95% CI, 0.007-0.038) and 0.06 (95% CI, 0.021-0.093), SD increase in PP per 1 SD increase in gray matter volume and white matter hyperintensities, higher odds of having a silent brain lesions pooled odds ratio of 1.11 (95% CI, 1.03-1.20) for 1 SD increase in PP, and cortical beta-amyloid (pooled estimate not available). There was limited evidence of an association with hippocampal volume, fractional anisotropy and mean diffusivity, cerebral microbleeds, cerebral blood flow and velocity, and cerebral metabolism. Longitudinal studies reported a negative…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 20 participants or records.
Read the paper
Related studies
- Learning from First-Generation Qualitative Approaches in the IS Discipline: An Evolutionary View and Some Implications for Authors and Evaluators (PART 1/2)
- Commentary on the clinical and preclinical dosage limits of interstitially administered magnetic fluids for therapeutic hyperthermia based on current practice and efficacy models
- Prosthesis: New Technological Opportunities and Innovative Biomedical Devices
- The history and future of neural modeling for cochlear implants
- Ryanodine receptors: waking up from refractoriness
- Novel Transgenic Rabbit Model Sheds Light on the Puzzling Role of Matrix Metalloproteinase-12 in Atherosclerosis
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.