Conclusions
vessel disease, hypertension, small vessel disease
SECONDARY, HYPERTENSION
In this post hoc secondary analysis of a randomized clinical trial of SBP control, intensive treatment, compared with standard treatment, of hypertension was associated with decreased progression of WMLs, specifically in the left anterior corona radiata, left tapetum, left superior fronto-occipital fasciculus, posterior thalamic radiations, left posterior corona radiata, and left splenium of the corpus callosum. Corresponding changes in mean FA (in overlapping regions, mainly the left posterior thalamic radiation, left superior fronto-occipital fasciculus, left anterior limb of internal capsule, left tapetum, and right anterior corona radiata) and MD (mainly in the left superior fronto-occipital fasciculus, left posterior thalamic radiation, and left tapetum) had a marginal association among other regions, suggesting the vulnerability of those regions to hypertension. Intensive SBP control was also associated with improved posterior cerebral perfusion. Our findings support the hypothesis that intensive BP treatment has beneficial associations with small vessel disease biomarkers. Specific areas show greater benefit, representing sensitive regions to track in future trials evaluating small vessel disease.