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P2‐276: Decreased Posterior Gray Matter Volumes in Women who Experienced Hypertensive Pregnancies and Have Late‐Life Hypertension
Author(s) -
Raman Mekala R.,
Tosakulwong Nirubol,
Preboske Gregory M.,
White Wendy M.,
Fields Julie A.,
Mielke Michelle M.,
Jack Clifford R.,
Miller Virginia M.,
Garovic Vesna D.,
Kantarci Kejal
Publication year - 2016
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2016.06.1536
Subject(s) - medicine , preeclampsia , pregnancy , chronic hypertension , gestational hypertension , obstetrics , pediatrics , genetics , biology
Background:Hypertensive events during pregnancy, including preeclampsia, are associated with a higher risk of future cardiovascular events and hypertension. However, little is known about their impact on brain structure and cognitive health. This study in women who experienced preeclampsia investigated differences in gray matter volumes on structural MRI between women who had hypertension 35-40 years after the incident pregnancy and those who did not.Methods:Women who have previously experienced preeclampsia were identified through the Rochester Epidemiology Project (REP) medical records-linkage system (n1⁄440; mean age 59). To be eligible, they had to be a resident of Olmsted County, MN when delivering a baby from a pregnancy lasting >20 weeks between 1976 through 1982. Of this group, 24 participants had hypertension later in life and 16 participants did not. All participants underwent a 3D T1-weighted MRI at 3 Tesla. Total gray matter volume was calculated using FreeSurfer version 5.3 and group differences were assessed using Wilcoxon Rank Sum tests. Voxel-based analysis for group differences using two-sided t-tests was performed in SPM5. Results:Women who had hypertension later in life had smaller total gray matter volumes than the women who did not have late-life hypertension (p1⁄40.03). This difference was localized in the occipital lobes with some involvement of the precuneus on voxel-based analysis (p<0.001; uncorrected for multiple comparisons) (Figure). Conclusions:Previous neuroimaging studies of women at the time of eclamptic pregnancies demonstrated vasogenic edema involving the posterior circulation. In a fraction of these patients neuroimaging abnormalities persist up to 6 weeks postpartum, presumably caused by gliosis. However, long-term follow-up of these women is not available. Our results indicate that in women with histories of preeclampsia, those who have hypertension later in life demonstrate structural changes in the occipital lobe that are not seen in women who did not have late-life hypertension. The long-term effects of these brain structural changes on cognitive function need to be investigated.