{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:15:24Z","timestamp":1776122124075,"version":"3.50.1"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Few studies have examined the separate contributions of systolic blood pressure and diastolic blood pressures (DBP) on subclinical cerebrovascular disease, especially using the 2017 American College of Cardiology\/American Heart Association Blood Pressure Guidelines. Furthermore, associations with region-specific white matter hyperintensity volume (WMHV) are underexplored.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Using data from the NOMAS (Northern Manhattan Study), a prospective cohort study of stroke risk and cognitive aging, we examined associations between systolic blood pressure and DBP, defined by the 2017 American College of Cardiology\/American Heart Association guidelines, with regional WMHV. We used a linear mixed model approach to account for the correlated nature of regional brain measures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              The analytic sample (N=1205; mean age 64\u00b18 years) consisted of 61% women and 66% Hispanics\/Latinos. DBP levels were significantly related to WMHV differentially across regions (\n              <jats:italic>P<\/jats:italic>\n              for interaction&lt;0.05). Relative to those with DBP 90+ mm\u2009Hg, participants with DBP &lt;80 mm\u2009Hg had 13% lower WMHV in the frontal lobe (95% CI, \u221221% to \u22123%), 11% lower WMHV in the parietal lobe (95% CI, \u221219% to \u22121%), 22% lower WMHV in the anterior periventricular region (95% CI, \u221230% to \u221214%), and 16% lower WMHV in the posterior periventricular region (95% CI, \u221224% to \u22126%). Participants with DBP 80 to 89 mm\u2009Hg also exhibited about 12% (95% CI, \u221220% to \u22123%) lower WMHV in the anterior periventricular region and 9% (95% CI, \u221218% to \u22120.4%) lower WMHV in the posterior periventricular region, relative to participants with DBP 90\u2265 mm\u2009Hg. Post hoc pairwise\n              <jats:italic>t<\/jats:italic>\n              tests showed that estimates for periventricular WMHV were significantly different from estimates for temporal WMHV (Holms stepdown\u2013adjusted\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05). Systolic blood pressure was not strongly related to regional WMHV.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Lower DBP levels, defined by the 2017 American College of Cardiology\/American Heart Association guidelines, were related to lower white matter lesion load, especially in the periventricular regions relative to the temporal region.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.119.025139","type":"journal-article","created":{"date-parts":[[2020,1,8]],"date-time":"2020-01-08T10:00:20Z","timestamp":1578477620000},"page":"372-378","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Diastolic Blood Pressure Is Associated With Regional White Matter Lesion Load"],"prefix":"10.1161","volume":"51","author":[{"given":"Michelle R.","family":"Caunca","sequence":"first","affiliation":[{"name":"From the Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences (M.R.C., R.L.S., T.R.), University of Miami, FL"},{"name":"Department of Neurology (M.R.C., M.S., R.L.S., T.R.), University of Miami, FL"},{"name":"Miller School of Medicine, Evelyn F. McKnight Brain Institute (M.R.C., N.A., R.L.S., T.R.), University of Miami, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marialaura","family":"Simonetto","sequence":"additional","affiliation":[{"name":"Department of Neurology (M.R.C., M.S., R.L.S., T.R.), University of Miami, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying Kuen","family":"Cheung","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Mailman School of Public Health (Y.K.C.), Columbia University, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noam","family":"Alperin","sequence":"additional","affiliation":[{"name":"Department of Radiology (N.A., S.H.L.), University of Miami, FL"},{"name":"Miller School of Medicine, Evelyn F. McKnight Brain Institute (M.R.C., N.A., R.L.S., T.R.), University of Miami, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang H.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology (N.A., S.H.L.), University of Miami, FL"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitchell S.V.","family":"Elkind","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Mailman School of Public Health, and Department of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E.), Columbia University, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph L.","family":"Sacco","sequence":"additional","affiliation":[{"name":"From the Division of Epidemiology and Population Health Sciences, Department of Public Health Sciences (M.R.C., R.L.S., T.R.), University of Miami, FL"},{"name":"Department of Neurology (M.R.C., M.S., R.L.S., T.R.), University of Miami, FL"},{"name":"Miller School of Medicine, Evelyn F. 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