{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:17:41Z","timestamp":1790061461195,"version":"4.0.1"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The aim of this study was to investigate the associations between pulse pressure (PP) and age\u2010related structural brain changes including brain volumes, white matter hyperintensities (WMH), fractional anisotropy, silent brain lesions, microbleeds, cerebral blood flow and metabolism, and beta\u2010amyloid accumulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Systematic review of PubMed (MEDLINE), Scopus, and Ovid Embase (from inception to January 2023) and references of included studies among adult populations was conducted. Findings were summarized narratively and by performing a fixed\u2010effects meta\u2010analysis. Publication bias was tested by a funnel plot and Egger's regression asymmetry test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Forty\u2010seven studies (7 longitudinal) were included (&gt;20\u2009000 participants). In cross\u2010sectional studies, PP consistently positively associated with gray matter volume and white matter hyperintensities with pooled standardized regression coefficients of 0.02 (95% CI, 0.007\u20130.038) and 0.06 (95% CI, 0.021\u20130.093), SD increase in PP per 1 SD increase in gray matter volume and white matter hyperintensities, higher odds of having a silent brain lesions pooled odds ratio of 1.11 (95% CI, 1.03\u20131.20) for 1 SD increase in PP, and cortical beta\u2010amyloid (pooled estimate not available). There was limited evidence of an association with hippocampal volume, fractional anisotropy and mean diffusivity, cerebral microbleeds, cerebral blood flow and velocity, and cerebral metabolism. Longitudinal studies reported a negative association between PP and change in hippocampal volume and positive association with cortical beta\u2010amyloid accumulation, but inconsistent findings were reported for total brain volume and white matter hyperintensities. Longitudinal studies were not available for gray matter volume, fractional anisotropy, silent brain lesions, cerebral microbleeds, and metabolism. Meta\u2010regression provided no evidence that mean study\u2010level arterial pressure modified the relationship between PP and associated brain metric.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cross\u2010sectional studies suggest a significant positive association between PP to gray matter volume, WMH, silent brain lesions, and cortical beta\u2010amyloid that warrants further investigation by sufficiently powered longitudinal studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.040013","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T04:38:52Z","timestamp":1757133532000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Association Between Pulse Pressure and Structural Brain Changes in Aging: A Systematic 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