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Modularity, rich\u2010club organization (rich\u2010club, feeder and local connections), small\u2010world property, global efficiency, local efficiency, clustering coefficient, and nodal efficiency were quantified using graph\u2010theoretical analysis. Network\u2010based statistics (NBS) were applied to identify significant group differences in white matter connectivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Statistical Tests<\/jats:title><jats:p>Analysis of variance for group comparisons, with post hoc least significant difference t\u2010testing. Logistic regression assessed the predictive power of network features, while Pearson correlation evaluated relationships between blood pressure and network disruptions. Area under the receiver operating characteristic (ROC) curve (AUC) was used to assess diagnostic performance. A significance threshold of <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 was applied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prehypertensive individuals exhibited significant early reductions in feeder connections, whereas hypertensive patients demonstrated widespread significant deterioration in rich\u2010club connections. A statistically significant compensatory increase in local connection strength was observed in prehypertension but declined in hypertension. Logistic regression confirmed that rich\u2010club connection strength and density effectively differentiated hypertensive individuals, with ROC analysis showing good discriminatory power (AUC: 0.803 and 0.816, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Conclusion<\/jats:title><jats:p>This study showed progressive disruption of rich\u2010club organization in prehypertension and hypertension. This disruption has the potential to be an early neuroimaging biomarker for identifying individuals at risk of hypertension\u2010related brain dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Evidence Level<\/jats:title><jats:p>2.<\/jats:p><\/jats:sec><jats:sec><jats:title>Technical Efficacy<\/jats:title><jats:p>Stage 2.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29835","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:19:40Z","timestamp":1749727180000},"page":"1079-1091","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of Elevated Blood Pressure on Rich\u2010Club Organization: A Multicenter <scp>MR<\/scp> Diffusion Tensor Imaging Study From Prehypertension to Hypertension"],"prefix":"10.1002","volume":"62","author":[{"given":"Yang","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiology Affiliated People's Hospital of Jiangsu 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