{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:25:44Z","timestamp":1792589144070,"version":"4.5.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,9,10]],"date-time":"2021-09-10T00:00:00Z","timestamp":1631232000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206589\/Z\/17\/Z"],"award-info":[{"award-number":["206589\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>White matter hyperintensities are the commonest manifestation of cerebral small vessel disease, associated with stroke, functional impairment, and cognitive decline. They are commonly preceded by hypertension, but the magnitude and clinical importance of this association is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Quantify the relationship between blood pressure and white matter hyperintensities across studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed and EMBASE were searched for studies reporting associations between concurrent or historic blood pressure and white matter hyperintensities. Beta coefficients from linear models were extracted, whether standardized, unstandardized, unadjusted or adjusted for age, sex, and cardiovascular risk factors. Beta-coefficients were combined by fixed and random effects meta-analysis, combining standardized beta-coefficients or unstandardized coefficients measured by consistent methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-five of 3230 papers were eligible, including 53,392 participants. Systolic blood pressure was significantly associated with white matter hyperintensity volume (WMHV) after maximal adjustment (standardized beta 0.096, 95%CI 0.06\u20130.133, p\u2009&lt;\u20090.001, I\n                      <jats:sup>2\u2009<\/jats:sup>\n                      =\u200965%), including for concurrent readings (b\u2009=\u20090.106, p\u2009&lt;\u20090.001) or readings five years previously (b\u2009=\u20090.077, p\u2009&lt;\u20090.001), and for younger or older populations (mean age\u2009&lt;\u200965: b\u2009=\u20090.114; &gt;65\u2009b\u2009=\u20090.069). Unstandardized, adjusted associations were similar for raw WMHV, log-transformed WMHV, or WMHV as percentage of intracranial volume. Unadjusted associations with systolic blood pressure (SBP) were greater (standardized beta\u2009=\u20090.273, 0.262\u20130.284, p\u2009&lt;\u20090.0001). However, while associations with DBP were weaker than SBP (standardized beta\u2009=\u20090.065, p\u2009&lt;\u20090.001), they were minimally affected by adjustment for age.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A standard deviation increase in SBP is associated with 10% of a standard deviation increase in WMHV, providing the current best estimate of the potential reduction in progression of white matter hyperintensities expected with good control of blood pressure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930211043364","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T09:37:43Z","timestamp":1629797863000},"page":"291-298","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Consistency of associations of systolic and diastolic blood pressure with white matter hyperintensities: A meta-analysis"],"prefix":"10.1177","volume":"17","author":[{"given":"Imogen","family":"Wilkinson","sequence":"first","affiliation":[{"name":"Centre for Prevention of Stroke and Dementia, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0630-8204","authenticated-orcid":false,"given":"Alastair John Stewart","family":"Webb","sequence":"additional","affiliation":[{"name":"Centre for Prevention of Stroke and Dementia, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,10]]},"reference":[{"key":"bibr1-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70124-8"},{"key":"bibr2-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31826b951e"},{"key":"bibr3-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.020379"},{"key":"bibr4-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291709990857"},{"key":"bibr5-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2477"},{"key":"bibr6-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa756"},{"key":"bibr7-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.014547"},{"key":"bibr8-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10551"},{"key":"bibr9-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.12.050"},{"key":"bibr10-17474930211043364","unstructured":"Tools SQA. National heart, lung, and blood institute (NHLBI), https:\/\/www.nhlbi.nih.gov\/health-topics\/study-quality-assessment-tools."},{"key":"bibr11-17474930211043364","unstructured":"Higgins JPT GSe.\n                      Cochrane handbook for systematic reviews of interventions.\n                      Version 5.1.0. London: The Cochrane Collaboration, 2011."},{"key":"bibr12-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"bibr13-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.106.078691"},{"key":"bibr14-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.961052"},{"key":"bibr15-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.113.02735"},{"key":"bibr16-17474930211043364","doi-asserted-by":"crossref","unstructured":"Lane CA BJ, Nicholas JM, Sudre CH, et\u00a0al. Associations between blood pressure across adulthood and late-life brain structure and pathology in the neuroscience substudy of the 1946 British birth cohort (Insight 46): an epidemiological study.\n                      Lancet Neurol\n                      2019; 18: 942\u2013952.","DOI":"10.1016\/S1474-4422(19)30228-5"},{"key":"bibr17-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.037036"},{"key":"bibr18-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.57.9.1302"},{"key":"bibr19-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpy104"},{"key":"bibr20-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25396"},{"key":"bibr21-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.21442"},{"key":"bibr22-17474930211043364","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2016.07.018"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17474930211043364","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17474930211043364","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17474930211043364","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:20:01Z","timestamp":1777706401000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17474930211043364"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,10]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["10.1177\/17474930211043364"],"URL":"https:\/\/doi.org\/10.1177\/17474930211043364","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,10]]}}}