{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:45:17Z","timestamp":1790703917026,"version":"4.1.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2020,3,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>High blood pressure (BP) is a known risk factor for mobility and cognitive impairment in older adults. This study tested the association of cumulative BP exposure from young adulthood to midlife with gait and cognitive function in midlife. Furthermore, we tested whether these associations were modified by cerebral white matter hyperintensity (WMH) burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We included 191 participants from the CARDIA study (Coronary Artery Risk Development in Young Adults), a community-based cohort of young individuals followed over 30 years. Cumulative BP was calculated as the area under the curve (mm\u2009Hg\u00d7years) from baseline up to year 30 examination. Gait and cognition were assessed at the year 30 examination. Cerebral WMH was available at year 30 in a subset of participants (n=144) who underwent magnetic resonance imaging. Multiple linear regression models were used to assess the association of cumulative BP exposure with gait and cognition. To test effect modification by WMH burden, participants were stratified at the median of WMH and tested for interaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Higher cumulative systolic and diastolic BPs were associated with slower walking speed (both\n                      <jats:italic>P<\/jats:italic>\n                      =0.010), smaller step length (\n                      <jats:italic>P<\/jats:italic>\n                      =0.011 and 0.005, respectively), and higher gait variability (\n                      <jats:italic>P<\/jats:italic>\n                      =0.018 and 0.001, respectively). Higher cumulative systolic BP was associated with lower cognitive performance in the executive (\n                      <jats:italic>P<\/jats:italic>\n                      =0.021), memory (\n                      <jats:italic>P<\/jats:italic>\n                      =0.015), and global domains (\n                      <jats:italic>P<\/jats:italic>\n                      =0.010), and higher cumulative diastolic BP was associated with lower cognitive performance in the memory domain (\n                      <jats:italic>P<\/jats:italic>\n                      =0.012). All associations were independent of socio-demographics and vascular risk factors (body mass index, smoking, diabetes mellitus and total cholesterol). The association between cumulative BP and gait was moderated by WMH burden (interaction\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05). However, the relation between cumulative BP and cognitive function was not different based on the WMH burden (interaction\n                      <jats:italic>P<\/jats:italic>\n                      &gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Exposure to higher BP levels from young to midlife is associated with worse gait and cognitive performance in midlife. Furthermore, WMH moderates the association of cumulative BP exposure with gait, but not with cognitive function in midlife. The mechanisms underpinning the impact of BP exposure on brain structure and function must be investigated in longitudinal studies using a life course approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.119.042502","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T05:00:36Z","timestamp":1574312436000},"page":"712-724","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":118,"title":["Cumulative Blood Pressure Exposure During Young Adulthood and Mobility and Cognitive Function in Midlife"],"prefix":"10.1161","volume":"141","author":[{"given":"Simin","family":"Mahinrad","sequence":"first","affiliation":[{"name":"Departments of Neurology (S.M., S.K., C.R.G., A.J.N., F.A.S.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Kurian","sequence":"additional","affiliation":[{"name":"Departments of Neurology (S.M., S.K., C.R.G., A.J.N., F.A.S.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaney R.","family":"Garner","sequence":"additional","affiliation":[{"name":"Departments of Neurology (S.M., S.K., C.R.G., A.J.N., F.A.S.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanaz","family":"Sedaghat","sequence":"additional","affiliation":[{"name":"Preventive Medicine (S.S., D.M.L.-J.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Nemeth","sequence":"additional","affiliation":[{"name":"Departments of Neurology (S.M., S.K., C.R.G., A.J.N., F.A.S.), Northwestern University Feinberg School of Medicine, Chicago, IL."},{"name":"Department of Radiology, Division of Neuroradiology (A.J.N.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Moscufo","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA (N.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Radiology and Biomedical Engineering (J.P.H.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (D.R.J.Jr.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Hausdorff","sequence":"additional","affiliation":[{"name":"Center for the Study of Movement Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Israel (J.M.H.)."},{"name":"Sagol School of Neuroscience and Department of Physical Therapy, Tel Aviv University, Israel (J.M.H.)."},{"name":"Rush Alzheimer\u2019s Disease Center and Department of Orthopaedic Surgery, Rush University, Chicago, IL (J.M.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M.","family":"Lloyd-Jones","sequence":"additional","affiliation":[{"name":"Preventive Medicine (S.S., D.M.L.-J.), Northwestern University Feinberg School of Medicine, Chicago, IL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzaneh A.","family":"Sorond","sequence":"additional","affiliation":[{"name":"Departments of Neurology (S.M., S.K., C.R.G., A.J.N., F.A.S.), 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