Introduction
stroke, cardiovascular disease, hypertension, Hypertension
CARDIOVASCULAR DISEASE, STROKE, SECONDARY, HYPERTENSION, BLOOD, HYPERTENSION
Hypertension is a major risk factor for cardiovascular disease and stroke,Fractional anisotropy (FA) and mean diffusivity (MD) are quantitative metrics calculated from diffusion magnetic resonance imaging (MRI). Fractional anisotropy describes the directional coherence of water diffusion in tissue and is generally interpreted as a quantitative biomarker for white matter (WM) integrity, while MD describes the overall diffusion of water molecules and typically has a low value in WM.Previous randomized, prospective trials with few participants and a brief trial duration have assessed the effect of blood pressure (BP) control on cerebral perfusion, with mixed findings.We hypothesized that antihypertensive treatment would be associated with protection of frontal brain regions. Toward that, we compared regional WML changes throughout the brain between a group receiving intensive BP control and a group receiving standard BP control. We further characterized the nature of the WM microstructural changes using regional DTI analysis and investigated as a secondary hypothesis that intensive hypertension management would be associated with regional improvement in CBF. We used the Systolic Blood Pressure Intervention Trial (SPRINT) Memory and Cognition in Decreased Hypertension (MIND) clinical trial, which is a large-scale multisite landmark study that demonstrated improved cognition and brain reserve in the group that received intensive systolic BP (SBP) control. We expand on previous reports