{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:29Z","timestamp":1790312429798,"version":"4.1.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Long\u2010term blood pressure variability (BPV) has been proposed as a potential risk factor for dementia and cerebral small vessel disease progression. In this study, we investigate the association between BPV, brain injury, and cognitive decline in probable cerebral amyloid angiopathy (CAA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using a prospective memory clinic cohort, we enrolled 102 participants, including 52 with probable CAA and mild cognitive symptoms. BPV was assessed using a coefficient of variation derived from outpatient BP measurements (median 12) over 5\u2009years before imaging with 3\u2010tesla research magnetic resonance imaging. We measured peak width of skeletonized mean diffusivity and neuroimaging markers of CAA, including lacunes and cortical cerebral microinfarcts. Using regression models, we evaluated the association of BPV with white matter integrity and whether CAA modified this association. We also examined the association of BPV with longitudinal cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Systolic BPV had a dose\u2010dependent association with peak width of skeletonized mean diffusivity (standardized \u03b2=0.22, 95% CI: 0.06\u20130.39,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.010), independent of age, sex, mean BP, common vascular risk factors, brain atrophy, and CAA severity. The presence of probable CAA strengthened the association between BPV and peak width of skeletonized mean diffusivity (\u03b2=9.33, 95% CI: 1.32\u201317.34,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      for interaction=0.023). Higher BPV correlated with the presence of lobar lacunes, cortical cerebral microinfarcts, and a decline in global cognition and processing speed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Long\u2010term BPV had a dose\u2010dependent association with altered white matter integrity, ischemic brain injury, and cognitive decline. Controlling BPV might be a potential novel therapeutic target to prevent cognitive decline in memory clinic patients with probable CAA and mild cognitive symptoms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.039087","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T12:14:28Z","timestamp":1781525668000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Blood Pressure Variability in Cerebral Amyloid Angiopathy is Associated with Ischemic Brain Injury and Cognitive Decline"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8015-7929","authenticated-orcid":false,"given":"Lukas","family":"Sveikata","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Geneva University Hospital and University of Geneva","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6604-0660","authenticated-orcid":false,"given":"Maria Clara","family":"Zanon Zotin","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo","place":["Ribeir\u00e3o Preto, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2587-8883","authenticated-orcid":false,"given":"Dorothee","family":"Schoemaker","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0207-3620","authenticated-orcid":false,"given":"Yuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Harvard T.H. Chan School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3551-5237","authenticated-orcid":false,"given":"Valentina","family":"Perosa","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7973-8267","authenticated-orcid":false,"given":"Anthipa","family":"Chokesuwattanaskul","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]},{"name":"Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-337X","authenticated-orcid":false,"given":"Andreas","family":"Charidimou","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2302-3136","authenticated-orcid":false,"given":"Marco","family":"Duering","sequence":"additional","affiliation":[{"name":"LMU University Hospital, LMU Munich","place":["Munich, Germany"]},{"name":"Antaros Medical AB","place":["M\u00f6lndal, Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-4457","authenticated-orcid":false,"given":"M. Edip","family":"Gurol","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0999-1034","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Assal","sequence":"additional","affiliation":[{"name":"Geneva University Hospital and University of Geneva","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1792-8887","authenticated-orcid":false,"given":"Steven M.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5398-1816","authenticated-orcid":false,"given":"Anand","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0281-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30079-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000913"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.18.2.311"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23566"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30346-5"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22516"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(22)00208-3"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2015.04.009"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21442"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10551"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60309-1"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60308-X"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60235-8"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14056"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.03.043"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.026739"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291717002756"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbae121"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17797"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012065"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022206"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(10)70066-1"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.1051038"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7042"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.24758"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.3122"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000142966.22886.20"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.212780"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30196-5"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011631"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00131-X"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011745"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016990"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.10082"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.0832"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2013.11.027"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0896-6273(02)00569-x"},{"key":"e_1_3_2_40_2","unstructured":"Schmidt P. Bayesian inference for structured additive regression models for large\u2010scale problems with applications to medical imaging. 2016."},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2019.09.003"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004007"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00114-X"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25512"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.118.10900"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/003591576505800503"},{"key":"e_1_3_2_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2018.05.027"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200136"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-198601000-00007"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000024523.82311.77"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.26761"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00293-4"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X211020863"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.040823"}],"updated-by":[{"DOI":"10.1161\/jaha.125.045439","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000}}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.124.039087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:46:11Z","timestamp":1789551971000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.124.039087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,16]]},"references-count":53,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,6,16]]}},"alternative-id":["10.1161\/JAHA.124.039087"],"URL":"https:\/\/doi.org\/10.1161\/jaha.124.039087","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,16]]},"assertion":[{"value":"2024-12-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e039087"}}