(HealthDay News) – In patients with arterial disease, having a low baseline diastolic blood pressure is associated with greater brain atrophy, while declining blood pressure is associated with less brain atrophy, according to a study published online June 10 in JAMA Neurology.

Noting that the association between blood pressure and brain atrophy has been unclear, Hadassa M. Jochemsen, MD, from the University Medical Center Utrecht in the Netherlands, and colleagues prospectively examined baseline blood pressure and changes in blood pressure in 663 patients with manifest arterial disease (coronary artery disease, cerebrovascular disease, peripheral artery disease, or abdominal aortic aneurysm).

The researchers found that after a mean follow-up of 3.9 years, and after adjusting for possible confounding factors, lower baseline diastolic blood pressure or mean arterial pressure was associated with greater progression of subcortical atrophy. In patients with higher baseline blood pressure (diastolic, systolic, or mean arterial), declining blood pressure over time was associated with less progression of subcortical atrophy compared to that seen in patients whose blood pressure was rising.

“This could imply that blood pressure lowering is beneficial in patients with higher blood pressure levels, but caution should be taken with further blood pressure lowering in patients who already have a low diastolic blood pressure,” Jochemsen and colleagues conclude.

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