The European Heart Journal published a paper by Dr hab. Mateusz Siedliński and Prof. Tomasz Guzik from the Jagiellonian University Medical College Faculty of Medicine. His study is the first attempt at finding a causal relationship between arterial hypertension and its complications that affect the brain and its structures as well as human cognitive function.
The paper Genetic analyses identify brain structures related to cognitive impairment associated with elevated blood pressure, which is the result of international collaboration, identifies specific brain parameters which can potentially be affected by changes in blood pressure For instance, out of nearly 4,000 parameters acquired via MRI, more than 200 were affected by increased systolic blood pressure. The analysis was carried out on large amounts of data provided by institutions such as UK Biobank and International Consortium for Blood Pressure and was also designed to answer questions regarding the relationship between blood pressure and cognitive function.
Researchers investigated the impact of systolic (not diastolic) blood pressure on cognitive function and identified nine brain imaging parameters that can mediate this impact. Importantly, they attempted to replicate and translate the results in well-characterised Italian population. While randomised clinical studies related to specific areas of the brain can be difficult to perform, the authors of the paper propose that future preclinical and clinical research focuses on imaging, which can lead to more personalised approach to patients with arterial hypertension in the context of cognitive impairment. Additionally, identifying clinical parameters derived from imaging and related to hypertension and cognitive impairment may result in discovering alternative biomarkers in future clinical trials of antihypertensive treatments.
Detailed molecular characteristics of these brain structures, including RNA sequencing and spatial proteomics, can reveal biological pathways changed as a result of hypertension as well as cognitive impairment.
3D image identifying areas of the brain affected by systolic hypertension. Red areas are the most impacted by high blood pressure, while yellow ones are less affected. Research shows systolic hypertension causes damage to white matter and its connections to other parts of the brain, which leads to decreased cognitive function in subjects. For the first time, researchers identified specific parts of the brain that are impacted by hypertension and can be responsible for cognitive impairment (image courtesy of Dr Lorenzo Carnevale, IRCCS INM Neuromed, Pozzilli, Italy).