{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T11:05:33Z","timestamp":1770894333748,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropathology Appl Neurobio"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study assesses the association of antihypertensive medication use on the severities of neuropathological cerebrovascular disease (CVD excluding lobar infarction) in older individuals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and neuropathological data were retrieved for 149 autopsy cases &gt;75\u2009years old with or without CVD or Alzheimer's disease and no other neuropathological diagnoses. Clinical data included hypertension status, hypertension diagnosis, antihypertensive medication use, antihypertensive medication dose (where available) and clinical dementia rating (CDR). Neuropathological CVD severity was evaluated for differences with anti\u2010hypertensive medication usage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Antihypertensive medication use was associated with less severe white matter small vessel disease (SVD, mainly perivascular dilatation and rarefaction), with a 5.6\u201314.4 times greater likelihood of less severe SVD if medicated. No significant relationship was detected between infarction (presence, type, number and size), lacunes or cerebral amyloid angiopathy and antihypertensive medication use. Only increased white matter rarefaction\/oedema and not perivascular dilation was associated with Alzheimer's pathology, with a 4.3 times greater likelihood of reduced A\u03b2 progression through the brain if white matter rarefaction severity was none or mild. Antihypertensive medication use was associated with reduced A\u03b2 progression but only in those with moderate to severe white matter SVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This histopathological study provides further evidence that antihypertensive medication use in older individuals is associated with white matter SVD and not with other CVD pathologies. This is mainly due to a reduction in white matter perivascular dilation and rarefaction\/oedema. Even in those with moderate to severe white matter SVD, antihypertensive medication use reduced rarefaction and A\u03b2 propagation through the brain.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nan.12922","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T05:45:12Z","timestamp":1689054312000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Past antihypertensive medication use is associated with lower levels of small vessel disease and lower A\u03b2 plaque stage in the brains of older individuals"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4686-9003","authenticated-orcid":false,"given":"Andrew J.","family":"Affleck","sequence":"first","affiliation":[{"name":"Neuroscience Research Australia (NeuRA)  Sydney Australia"},{"name":"Centre for Health Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine University of 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