Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: the Cardiovascular Health Study.


BACKGROUND:Our objective was to investigate the association between hypertension and concurrent impairments in mobility, cognition, and mood; the role of brain white matter hyperintensities in mediating this association; and the impact of these impairments on disability and mortality in elderly hypertensive individuals. METHODS AND RESULTS:-Blood pressure, gait speed, digit symbol substitution test, and the Center for Epidemiological Studies Depression Scale were measured yearly (1992-1999) on 4700 participants in the Cardiovascular Health Study (age: 74.7, 58% women, 17% blacks, 68% hypertension, 3600 had brain magnetic resonance imaging in 1992-1993, survival data 1992-2005). Using latent profile analysis at baseline, we found that 498 (11%) subjects had concurrent impairments and 3086 (66%) were intact on all 3 measures. Between 1992 and 1999, 651 (21%) became impaired in all 3 domains. Hypertensive individuals were more likely to be impaired at baseline (odds ratio 1.23, 95% confidence interval 1.04 to 1.42, P=0.01) and become impaired during the follow-up (hazard ratio=1.3, 95% confidence interval 1.02 to 1.66, P=0.037). A greater degree of white matter hyperintensities was associated with impairments in the 3 domains (P=0.007) and mediated the association with hypertension (P=0.19 for hypertension after adjusting for white matter hyperintensities in the model, 21% hazard ratio change). Impairments in the 3 domains increased subsequent disability with hypertension (P<0.0001). Hypertension mortality also was increased in those impaired (compared with unimpaired hypertensive individuals: HR=1.10, 95% confidence interval 1.04 to 1.17, P=0.004). CONCLUSIONS:Hypertension increases the risk of concurrent impairments in mobility, cognition, and mood, which increases disability and mortality. This association is mediated in part by microvascular brain injury.






Hajjar I,Quach L,Yang F,Chaves PH,Newman AB,Mukamal K,Longstreth W Jr,Inzitari M,Lipsitz LA




Has Abstract


2011-03-01 00:00:00














  • Evaluation of infradiaphragmatic total anomalous pulmonary venous connection with two-dimensional echocardiography.

    abstract::In three newborn infants with infradiaphragmatic total anomalous pulmonary venous connection, the common pulmonary vein was visualized with two-dimensional echocardiography and validated with saline contrast injections. The transducer was placed in the subcostal region in a sagittal body plane so as to image the desce...


    pub_type: 杂志文章


    authors: Snider AR,Silverman NH,Turley K,Ebert PA

    更新日期:1982-11-01 00:00:00

  • LPA Gene, Ethnicity, and Cardiovascular Events.

    abstract:BACKGROUND:The relationship of LPA single nucleotide polymorphisms (SNPs), apolipoprotein(a) isoforms, and lipoprotein(a) [Lp(a)] levels with major adverse cardiovascular events (MACE) in different ethnic groups is not well known. METHODS:LPA SNPs, apolipoprotein(a) isoforms, Lp(a), and oxidized phospholipids on apoli...


    pub_type: 杂志文章


    authors: Lee SR,Prasad A,Choi YS,Xing C,Clopton P,Witztum JL,Tsimikas S

    更新日期:2017-01-17 00:00:00

  • Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial.

    abstract:BACKGROUND:We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes). METHODS AND RESULTS:DiOGenes is a pan-European controlled dieta...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Gögebakan O,Kohl A,Osterhoff MA,van Baak MA,Jebb SA,Papadaki A,Martinez JA,Handjieva-Darlenska T,Hlavaty P,Weickert MO,Holst C,Saris WH,Astrup A,Pfeiffer AF,DiOGenes.

    更新日期:2011-12-20 00:00:00

  • Fluid restitution and blood volume redistribution in anesthetized rabbits in response to vasoactive drugs.

    abstract:BACKGROUND:Vasoactive drugs could alter the fluid restitution from the tissue and redistribute blood volume between the macrocirculation and microcirculation. METHODS AND RESULTS:With bolus injections of vasoactive drugs in anesthetized rabbits, we measured the changes in blood and plasma density for the determination...


    pub_type: 杂志文章


    authors: Anderson SM,Rich GF,Roos C,Lee LP,Lee JS

    更新日期:1994-07-01 00:00:00

  • Comparison of multiple views for the evaluation of pulmonary arterial blood flow by Doppler echocardiography.

    abstract::Forty adult patients underwent Doppler and two-dimensional echocardiographic examination of the pulmonary artery from multiple views to determine the variability in the magnitude of Doppler-determined flow velocity and pulmonary arterial diameter from various echocardiographic windows. Flows were recorded from two or ...


    pub_type: 杂志文章


    authors: Lighty GW Jr,Gargiulo A,Kronzon I,Politzer F

    更新日期:1986-11-01 00:00:00

  • Cost-effectiveness of prasugrel versus clopidogrel in patients with acute coronary syndromes and planned percutaneous coronary intervention: results from the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with Prasug

    abstract:BACKGROUND:In patients with acute coronary syndromes and planned percutaneous coronary intervention, the Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel-Thrombolysis in Myocardial Infarction 38 (TRITON-TIMI 38) demonstrated that treatment with prasugrel versus clopid...


    pub_type: 杂志文章


    authors: Mahoney EM,Wang K,Arnold SV,Proskorovsky I,Wiviott S,Antman E,Braunwald E,Cohen DJ

    更新日期:2010-01-05 00:00:00

  • Pathogenesis of edema in constrictive pericarditis. Studies of body water and sodium, renal function, hemodynamics, and plasma hormones before and after pericardiectomy.

    abstract:BACKGROUND:The pathogenesis of sodium and water accumulation in chronic constrictive pericarditis is not well understood and may differ from that in patients with chronic congestive heart failure due to myocardial disease. This study was undertaken to investigate some of the mechanisms. METHODS AND RESULTS:Using stand...


    pub_type: 杂志文章


    authors: Anand IS,Ferrari R,Kalra GS,Wahi PL,Poole-Wilson PA,Harris PC

    更新日期:1991-06-01 00:00:00

  • Antenatal sildenafil treatment attenuates pulmonary hypertension in experimental congenital diaphragmatic hernia.

    abstract:BACKGROUND:Lung hypoplasia and persistent pulmonary hypertension of the newborn limit survival in congenital diaphragmatic hernia (CDH). Unlike other diseases resulting in persistent pulmonary hypertension of the newborn, infants with CDH are refractory to inhaled nitric oxide (NO). Nitric oxide mediates pulmonary vaso...


    pub_type: 杂志文章


    authors: Luong C,Rey-Perra J,Vadivel A,Gilmour G,Sauve Y,Koonen D,Walker D,Todd KG,Gressens P,Kassiri Z,Nadeem K,Morgan B,Eaton F,Dyck JR,Archer SL,Thébaud B

    更新日期:2011-05-17 00:00:00

  • Enhanced Therapeutic and Long-Term Dynamic Vascularization Effects of Human Pluripotent Stem Cell-Derived Endothelial Cells Encapsulated in a Nanomatrix Gel.

    abstract:BACKGROUND:Human pluripotent stem cell (hPSC)-derived endothelial cells (ECs) have limited clinical utility because of undefined components in the differentiation system and poor cell survival in vivo. Here, we aimed to develop a fully defined and clinically compatible system to differentiate hPSCs into ECs. Furthermor...


    pub_type: 杂志文章


    authors: Lee SJ,Sohn YD,Andukuri A,Kim S,Byun J,Han JW,Park IH,Jun HW,Yoon YS

    更新日期:2017-11-14 00:00:00

  • Congestive heart failure after surgical correction of mitral regurgitation. A long-term study.

    abstract:BACKGROUND:In patients with mitral regurgitation, surgical intervention produces immediate improvement in symptoms, but the long-term incidence and significance of postoperative congestive heart failure are unknown. METHODS AND RESULTS:The long-term outcome of 576 operative survivors of surgical correction of pure mit...


    pub_type: 杂志文章


    authors: Enriquez-Sarano M,Schaff HV,Orszulak TA,Bailey KR,Tajik AJ,Frye RL

    更新日期:1995-11-01 00:00:00

  • Evaluation of combined valvular prolapse syndrome by two-dimensional echocardiography.

    abstract::The patterns of aortic and tricuspid valve motion in 50 patients with mitral valve prolapse were analyzed by wide-angle, phased-array, two-dimensional echocardiography. Twelve patients (24%) had redundant aortic leaflets bulging into the left ventricular outflow tract during diastole. Eight of 12 patients had aortic r...


    pub_type: 杂志文章


    authors: Ogawa S,Hayashi J,Sasaki H,Tani M,Akaishi M,Mitamura H,Sano M,Hoshino T,Handa S,Nakamura Y

    更新日期:1982-01-01 00:00:00

  • Corrected transposition with severe intracardiac deformities with Wolff-Parkinson-White syndrome in a child. Electrophysiologic investigation and surgical correction.

    abstract::This is a report of a 10-year-old child who underwent surgery for complex congenital heart disease consisting of corrected transposition of the great vessels, ventricular septal defect, patent ductus arterisus, severe left-sided atrioventricular (AV) valve insuffieicney (Ebstein's deformity) and Wolff-Parkinson-White ...


    pub_type: 杂志文章


    authors: Benson DW Jr,Gallagher JJ,Oldham HN,Sealy WC,Sterba R,Spach MS

    更新日期:1980-06-01 00:00:00

  • Magnetic resonance jet velocity mapping in mitral and aortic valve stenosis.

    abstract:BACKGROUND:Magnetic resonance (MR) phase-shift velocity mapping is an established method for measurement of nonturbulent intravascular flow. Shortening the echo time of the MR sequence to 3.6 msec allowed application of the technique to turbulent jet flow. The objective of this study was validation of MR jet velocity m...


    pub_type: 杂志文章


    authors: Kilner PJ,Manzara CC,Mohiaddin RH,Pennell DJ,Sutton MG,Firmin DN,Underwood SR,Longmore DB

    更新日期:1993-04-01 00:00:00

  • Early predictors of survival to and after heart transplantation in children with dilated cardiomyopathy.

    abstract:BACKGROUND:The importance of clinical presentation and pretransplantation course on outcome in children with dilated cardiomyopathy listed for heart transplantation is not well defined. METHODS AND RESULTS:The impact of age, duration of illness, sex, race, ventricular geometry, and diagnosis of myocarditis on outcome ...


    pub_type: 杂志文章,多中心研究


    authors: Pietra BA,Kantor PF,Bartlett HL,Chin C,Canter CE,Larsen RL,Edens RE,Colan SD,Towbin JA,Lipshultz SE,Kirklin JK,Naftel DC,Hsu DT

    更新日期:2012-08-28 00:00:00

  • Acute hemodynamic effects of captopril in children with a congestive or restrictive cardiomyopathy.

    abstract::The acute hemodynamic effects of captopril were evaluated at cardiac catheterization in 16 children (age, 0.3-18 years) with cardiomyopathy. Twelve children had congestive cardiomyopathy, whereas four had restrictive cardiomyopathy. Hemodynamic measurements were obtained 30 and 60 minutes after the oral administration...


    pub_type: 临床试验,杂志文章


    authors: Bengur AR,Beekman RH,Rocchini AP,Crowley DC,Schork MA,Rosenthal A

    更新日期:1991-02-01 00:00:00

  • Physical training alters the pathogenesis of pacing-induced heart failure through endothelium-mediated mechanisms in awake dogs.

    abstract:BACKGROUND:Beneficial effects of exercise training on cardiovascular function in chronic heart failure (CHF) have been suggested previously, but the underlying mechanisms are unknown. We tested whether daily exercise training improves systemic hemodynamics and preserves endothelium-mediated vasodilator function during ...


    pub_type: 杂志文章


    authors: Wang J,Yi GH,Knecht M,Cai BL,Poposkis S,Packer M,Burkhoff D

    更新日期:1997-10-21 00:00:00

  • Use of fresh decellularized allografts for pulmonary valve replacement may reduce the reoperation rate in children and young adults: early report.

    abstract:BACKGROUND:Degeneration of xenografts or homografts is a major cause for reoperation in young patients after pulmonary valve replacement. We present the early results of fresh decellularized pulmonary homografts (DPH) implantation compared with glutaraldehyde-fixed bovine jugular vein (BJV) and cryopreserved homografts...


    pub_type: 杂志文章,多中心研究


    authors: Cebotari S,Tudorache I,Ciubotaru A,Boethig D,Sarikouch S,Goerler A,Lichtenberg A,Cheptanaru E,Barnaciuc S,Cazacu A,Maliga O,Repin O,Maniuc L,Breymann T,Haverich A

    更新日期:2011-09-13 00:00:00

  • Effect of digoxin and diuretics on high altitude left ventricular dysfunction.

    abstract::Systolic time intervals, stroke volume, cardiac output and (dZ/dt)/RZ index were serially estimated in 51 normal healthy volunteers at sea level, for ten days after air induction to 3658 m altitude and on return to sea level. The subjects were divided into three groups and were administered a diuretic, beta methyldigo...


    pub_type: 临床试验,杂志文章


    authors: Balasubramanian V,Behl A,Das GS,Wadhwa AK,Mathew OP,Hoon RS

    更新日期:1978-06-01 00:00:00

  • Arrhythmia burden in adults with surgically repaired tetralogy of Fallot: a multi-institutional study.

    abstract:BACKGROUND:The arrhythmia burden in tetralogy of Fallot, types of arrhythmias encountered, and risk profile may change as the population ages. METHODS AND RESULTS:The Alliance for Adult Research in Congenital Cardiology (AARCC) conducted a multicenter cross-sectional study to quantify the arrhythmia burden in tetralog...


    pub_type: 杂志文章,多中心研究


    authors: Khairy P,Aboulhosn J,Gurvitz MZ,Opotowsky AR,Mongeon FP,Kay J,Valente AM,Earing MG,Lui G,Gersony DR,Cook S,Ting JG,Nickolaus MJ,Webb G,Landzberg MJ,Broberg CS,Alliance for Adult Research in Congenital Cardiology (AARCC).

    更新日期:2010-08-31 00:00:00

  • BMP9 and BMP10 Act Directly on Vascular Smooth Muscle Cells for Generation and Maintenance of the Contractile State.

    abstract::Background: Vascular smooth muscle cells (VSMCs) show a remarkable phenotypic plasticity allowing acquisition of contractile or synthetic states but critical information is missing about the physiological signals, promoting formation and maintenance of contractile VSMCs in vivo. BMP9 and BMP10 are known to regulate en...


    pub_type: 杂志文章


    authors: Wang L,Rice M,Swist S,Kubin T,Wu F,Wang S,Kraut S,Weissmann N,Böttger T,Wheeler M,Schneider A,Braun T

    更新日期:2020-12-18 00:00:00

  • Body iron stores and the risk of carotid atherosclerosis: prospective results from the Bruneck study.

    abstract:BACKGROUND:Fe2+ released from tissue iron stores may accelerate lipid peroxidation by virtue of its pro-oxidant properties and thus promote early atherogenesis. METHODS AND RESULTS:The present prospective survey addresses the potential association between serum ferritin concentrations and the 5-year progression of car...


    pub_type: 杂志文章


    authors: Kiechl S,Willeit J,Egger G,Poewe W,Oberhollenzer F

    更新日期:1997-11-18 00:00:00

  • Pharmacoangiographic manipulation of renal collateral blood flow.

    abstract::Vasodilatory or vasoconstrictive renal pharmacoangiography was applied in investigating the significance of 50 renal artery stenoses. The technique involves comparison of selective magnification renal arteriograms before and after intra-arterial injection of epinephrine or acetylcholine, seeking changes in direction o...


    pub_type: 杂志文章


    authors: Bookstein JJ,Walter JF,Stanley JC,Fry WJ

    更新日期:1976-08-01 00:00:00

  • Simultaneous epicardial and endocardial activation sequence mapping in the isolated canine right atrium.

    abstract:BACKGROUND:Since the atria are thin-walled structures, most studies that have examined the spread of activation in the atria have assumed that they behave electrophysiologically as a two-dimensional surface. It was the objective of this study to determine whether or not this assumption is true by simultaneously mapping...


    pub_type: 杂志文章


    authors: Schuessler RB,Kawamoto T,Hand DE,Mitsuno M,Bromberg BI,Cox JL,Boineau JP

    更新日期:1993-07-01 00:00:00

  • Benefits and risks of corticosteroid prophylaxis in adult cardiac surgery: a dose-response meta-analysis.

    abstract:BACKGROUND:Cardiopulmonary bypass and cardiac surgery are associated with a significant systemic inflammatory response that may increase postoperative complications. This meta-analysis assessed whether the benefits and risks of corticosteroid use were dose dependent in adult cardiac surgery. METHODS AND RESULTS:Random...


    pub_type: 杂志文章,meta分析


    authors: Ho KM,Tan JA

    更新日期:2009-04-14 00:00:00

  • Arteriographic evidence of coronary arterial spasm in acute myocardial infarction.

    abstract::Coronary arteriography was performed before and after the intracoronary injection of nitroglycerin to determine the presence or absence of spasm in patients within the first 12 hours of acute myocardial infarction. Coronary arterial spasm was demonstrated in six of fifteen (40%) acute myocardial infarctions associated...


    pub_type: 杂志文章


    authors: Oliva PB,Breckinridge JC

    更新日期:1977-09-01 00:00:00

  • Reduced baroreceptor sensitivity in borderline hypertension.

    abstract::The sensitivity of the baroreceptor reflex in nine patients with borderline hypertension (mean age 19.1 plus or minus 0.2 years) was compared to that in six normal subjects of comparable age (mean 18.8 plus or minus 0.3 years) and that in 14 patients with established hypertension (mean age 48.3 plus or minus 3.1 years...


    pub_type: 杂志文章


    authors: Takeshita A,Tanaka S,Kuroiwa A,Nakamura M

    更新日期:1975-04-01 00:00:00

  • Surgery for coarctation of the aorta in the neonate.

    abstract::Between 1972 and 1984, 100 consecutive neonates (less than or equal to 30 days old) underwent repair of coarctation of the aorta. Mean (+/- SD) age at operation was 12.0 +/- 8.0 days; mean weight was 3.1 +/- 0.5 kg. Simple coarctation was present in 29 patients (group I), 32 patients had additional ventricular septal ...


    pub_type: 杂志文章


    authors: Ziemer G,Jonas RA,Perry SB,Freed MD,Castaneda AR

    更新日期:1986-09-01 00:00:00

  • Effects of vagal stimulation on cesium-induced early afterdepolarizations and ventricular arrhythmias in rabbits.

    abstract:BACKGROUND:Previous evidence has shown that increased sympathetic tone enhances the cesium chloride (Cs)-induced early afterdepolarizations (EADs) and ventricular tachycardias (VTs). METHODS AND RESULTS:We assessed the effects of vagal stimulation on Cs-induced EADs and ventricular arrhythmias in the rabbit heart. Mon...


    pub_type: 杂志文章


    authors: Takahashi N,Ito M,Ishida S,Fujino T,Saikawa T,Arita M

    更新日期:1992-12-01 00:00:00

  • Pathogenesis of paradoxical hypertension after coarctation resection.

    abstract::The pathogenesis of paradoxical hypertension after resection of coarctation of the aorta was investigated by comparing the course of seven children undergoing repair of coarctation with five acyanotic children undergoing elective cardiovascular surgery. During the first 24 hours after surgery, all coarctation patients...


    pub_type: 杂志文章


    authors: Rocchini AP,Rosenthal A,Barger AC,Castaneda AR,Nadas AS

    更新日期:1976-09-01 00:00:00

  • Complete isolation of left atrium surrounding the pulmonary veins: new insights from the double-Lasso technique in paroxysmal atrial fibrillation.

    abstract:BACKGROUND:Paroxysmal atrial fibrillation (PAF) can be eliminated with continuous circular lesions (CCLs) around the pulmonary veins (PVs), but it is unclear whether all PVs are completely isolated. METHODS AND RESULTS:Forty-one patients with symptomatic PAF underwent 3D mapping, and all PV ostia were marked on the 3D...


    pub_type: 杂志文章


    authors: Ouyang F,Bänsch D,Ernst S,Schaumann A,Hachiya H,Chen M,Chun J,Falk P,Khanedani A,Antz M,Kuck KH

    更新日期:2004-10-12 00:00:00