Research advances in white matter lesions in patients with hypertension

He Yanhu, Jin Hua, Bai Lin, Ma Chao, Liu Minke, Liu Zhijun, Chen Dongsheng, Hu Zhixia

PDF(593 KB)
PDF(593 KB)
Journal of Chongqing Medical University ›› 2025, Vol. 50 ›› Issue (02) : 165-170. DOI: 10.13406/j.cnki.cyxb.003712
Review

Research advances in white matter lesions in patients with hypertension

Author information +
History +

Abstract

Hypertension,as the most common independent risk factor for cardiovascular and cerebrovascular diseases,does not cause discomfort due to elevated blood pressure itself,but causes damage to important target organs of the body and various complications due to prolonged course of hypertension or long-term high blood pressure. In addition to the research hotspots of cardiovascular and cerebrovascular complications caused by hypertension in recent years,the association between hypertension and small cerebral vascular disease has also gradually become a research hotspot. This article reviews the risk factors for white matter lesions in hypertensive patients,in order to provide individualized regimens to prevent the further progression of the disease.

Key words

hypertension / white matter lesions / influencing factors / complications

Cite this article

Download Citations
He Yanhu , Jin Hua , Bai Lin , et al . Research advances in white matter lesions in patients with hypertension. Journal of Chongqing Medical University. 2025, 50(02): 165-170 https://doi.org/10.13406/j.cnki.cyxb.003712

References

1
马新伟,许建铭,张明杰,等. 老年高血压患者脑白质病变在磁共振序列中的半定量评估[J]. 中华老年心脑血管病杂志201921(12):1305-1308.
Ma XW Xu JM Zhang MJ,et al. Semiquantitative assessment of white matter lesions in elderly hypertensive patients based on magnetic resonance sequences[J]. Chin J Geriatr Heart Brain Vessel Dis201921(12):1305-1308.
2
Mills KT Bundy JD Kelly TN,et al. Global disparities of hypertension prevalence and control:a systematic analysis of population-based studies from 90 countries[J]. Circulation2016134(6):441-450.
3
Wang ZW Chen Z Zhang LF,et al. Status of hypertension in China:results from the China hypertension survey,2012-2015[J]. Circulation2018137(22):2344-2356.
4
郑 刚. 高血压临床研究新进展[J]. 中华老年心脑血管病杂志201820(6):651-655.
Zheng G. New progress in clinical research of hypertension[J]. Chin J Geriatr Heart Brain Vessel Dis201820(6):651-655.
5
Wen W Sachdev PS Li JJ,et al. White matter hyperintensities in the forties:their prevalence and topography in an epidemiological sample aged 44-48[J]. Hum Brain Mapp200930(4):1155-1167.
6
Launer LJ Berger K Breteler MMB,et al. Regional variability in the prevalence of cerebral white matter lesions:an MRI study in 9 European countries(CASCADE)[J]. Neuroepidemiology200626(1):23-29.
7
Alber J Alladi S Bae HJ,et al. White matter hyperintensities in vascular contributions to cognitive impairment and dementia(VCID):knowledge gaps and opportunities[J]. Alzheimers Dement20195:107-117.
8
Kynast J Lampe L Luck T,et al. White matter hyperintensities associated with small vessel disease impair social cognition beside attention and memory[J]. J Cereb Blood Flow Metab201838(6):996-1009.
9
Dupont PS Bocti C Joannette M,et al. Amyloid burden and white matter hyperintensities mediate age-related cognitive differences[J]. Neurobiol Aging202086:16-26.
10
中国老年医学学会高血压分会. 中国老年高血压管理指南2019[J]. 中华高血压杂志201927(2):100.
China elderly hypertension management guidelines 2019[J]. Chin J Hypertens201927(2):100.
11
吕燕宇,张 兵,王惠君,等. 1991—2015年我国9省成年农民高血压患病率、知晓率和治疗率的变化趋势及人口经济学差异[J]. 中华流行病学杂志202041(4):498-503.
YY Zhang B Wang HJ,et al. Changing trends regarding the rates of prevalence,awareness and treatment of hypertension and the differences by demographic and economic factors,among adult farmers in nine provinces in China,from 1991 to 2015[J]. Chin J Epidemiol202041(4):498-503.
12
高砚丽,康 黎,张莹. 老年高血压患者认知功能损害与血压变异性、昼夜动脉血压情况、脉压指数的相关性[J]. 实用临床医药杂志202024(3):56-60.
Gao YL Kang L Zhang Y. Correlation between blood pressure variability,circadian arterial blood pressure,pulse pressure index and cognitive impairment in elderly patients with hypertension[J]. J Clin Med Pract202024(3):56-60.
13
何 敏,陈后勤,邵凌云,等. 脑白质疏松症的临床危险因素分析[J]. 中国实用神经疾病杂志201720(19):58-60.
He M Chen HQ Shao LY,et al. Clinical analysis of risk factors of leukoaraiosis[J]. Chin J Pract Nerv Dis201720(19):58-60.
14
Zhang D Tang Y Ge J,et al. Age and Diastolic Blood Pressure Play an Important Role in the Progression of White Matter Lesions:a Meta-Analysis[J]. Eur Neurol202083(4):351-359.
15
Zhao Y Ke ZY He WB,et al. Volume of white matter hyperintensities increases with blood pressure in patients with hypertension[J]. J Int Med Res201947(8):3681-3689.
16
Alateeq K Walsh EI Cherbuin N. Higher Blood Pressure is Associated with Greater White Matter Lesions and Brain Atrophy:a Systematic Review with Meta-Analysis[J]. J Clin Med202110(4):637.
17
Nosalski R McGinnigle E Siedlinski M,et al. Novel immune mechanisms in hypertension and cardiovascular risk[J]. Curr Cardiovasc Risk Rep201711(4):12.
18
Guzik TJ Touyz RM. Oxidative stress,inflammation,and vascular aging in hypertension[J]. Hypertension201770(4):660-667.
19
Mikolajczyk TP Nosalski R Szczepaniak P,et al. Role of chemokine RANTES in the regulation of perivascular inflammation,T-cell accumulation,and vascular dysfunction in hypertension[J]. FASEB J201630(5):1987-1999.
20
Ji X Leng XY Dong Y,et al. Modifiable risk factors for carotid atherosclerosis:a meta-analysis and systematic review[J]. Ann Transl Med20197(22):632.
21
Walker KA Power MC Gottesman RF. Defining the relationship between hypertension,cognitive decline,and dementia:a review[J]. Curr Hypertens Rep201719(3):24.
22
Wardlaw JM Smith C Dichgans M. Small vessel disease:mechanisms and clinical implications[J]. Lancet Neurol201918(7):684-696.
23
Duering M Righart R Wollenweber FA,et al. Acute infarcts cause focal thinning in remote cortex via degeneration of connecting fiber tracts[J]. Neurology201584(16):1685-1692.
24
Hamilton OKL Backhouse EV Janssen E,et al. Cognitive impairment in sporadic cerebral small vessel disease:a systematic review and meta-analysis[J]. Alzheimers Dement202117(4):665-685.
25
张 栋,何明利,葛 建,等. 收缩压与舒张压水平对脑白质病变的影响:Meta分析[J]. 中风与神经疾病杂志202037(7):600-606.
Zhang D He ML Ge J,et al. Effects of systolic blood pressure and diastolic blood pressure on White matter lesions:a meta-analysis[J]. J Apoplexy Nerv Dis202037(7):600-606.
26
范常锋,李 霞,赵亚锋,等. 脑白质病变病人相关危险因素分析[J]. 中西医结合心脑血管病杂志201917(8):1251-1253.
Fan CF Li X Zhao YF,et al. Analysis of related risk factors in patients with white matter lesions[J]. Chin J Integr Med Cardio Cerebrovasc Dis201917(8):1251-1253.
27
王 倩,郑春玲,张艳华,等. 缺血性脑白质病变患者认知功能障碍危险因素分析[J]. 郑州大学学报(医学版)202156(3):385-389.
Wang Q Zheng CL Zhang YH,et al. Study on risk factors of cognitive dysfunction in patients with ischemic leukoencephalopathy[J]. J Zhengzhou Univ Med Sci202156(3):385-389.
28
夏瑞雪,李艳华,张丽冉,等. 缺血性脑白质病变患者发生认知功能障碍的影响因素分析[J]. 解放军医药杂志201931(3):108-111.
Xia RX Li YH Zhang LR,et al. Pathogenesy influencing factors of cognitive dysfunction in patients with ischemic leukodystrophy[J]. Med Pharm J Chin People’s Liberation Army201931(3):108-111.
29
张 娟,张素爱,周善之. 血浆同型半胱胺酸水平与脑白质病变严重程度的相关性研究[J]. 中西医结合心血管病电子杂志20208(4):97-98.
Zhang J Zhang SA Zhou SZ. Correlation between plasma homocysteine level and severity of leukoencephalopathy[J]. Cardiovasc Dis Electron J Integr Tradit Chin West Med20208(4):97-98.
30
杨延芳,孙红国,江 毅,等. H型高血压与脑小血管病认知功能障碍相关性研究[J]. 中风与神经疾病杂志201835(8):715-718.
Yang YF Sun HG Jiang Y,et al. Relationship between H-type hypertension and cognitive impairment of cerebral small vessel disease[J]. J Apoplexy Nerv Dis201835(8):715-718.
31
肖武玉. 脑血管病患者同型半胱氨酸水平与认知功能的相关性[J]. 中国实用神经疾病杂志201619(3):77-79.
Xiao WY. Correlation between homocysteine level and cognitive function in patients with cerebrovascular disease[J]. Chin J Pract Nerv Dis201619(3):77-79.
32
杨 琳,刘 强. 脑小血管病发生与患者血尿酸、同型半胱氨酸水平相关性研究[J]. 陕西医学杂志202150(4):460-463.
Yang L Liu Q. Relationship between the occurrence of cerebral small vessel disease and the levels of blood uric acid and homocysteine[J]. Shaanxi Med J202150(4):460-463.
33
Wu JX Xue J Zhuang L,et al. Plasma parameters and risk factors of patients with post-stroke cognitive impairment[J]. Ann Palliat Med20209(1):45-52.
34
Liu WS Zhang LY Li S,et al. A Mendelian randomization study of plasma homocysteine levels and cerebrovascular and neurodegenerative diseases[J]. Front Genet202112:653032.
35
雷武刚,倪歆璟,赖维萍. 老年认知功能障碍患者血清中尿酸、同型半胱氨酸、叶酸水平与磁共振影像的相关性分析[J]. 中国卫生检验杂志202030(6):729-731,734.
Lei WG Ni XJ Lai WP. Correlation between serum uric acid,homocysteine,folate levels and magnetic resonance imaging in elderly patients with cognitive dysfunction[J]. Chin J Health Lab Technol202030(6):729-731,734.
36
郁 洁,王 滨,洪侃,等. 合并认知功能障碍的脑小血管病老年患者血同型半胱氨酸及炎症介质水平的改变及意义[J]. 川北医学院学报201833(4):496-499.
Yu J Wang B Hong K,et al. Change and significanceof plasma homocysteine and inflammatory mediators in elderly patients with cerebral small vessel disease combined with cognitive impairment[J]. J N Sichuan Med Coll201833(4):496-499.
37
Song H Bharadwaj PK Raichlen DA,et al. Association of homocysteine-related subcortical brain atrophy with white matter lesion volume and cognition in healthy aging[J]. Neurobiol Aging2023121:129-138.
38
支海鸯,陈 凌,黎斌. 血清同型半胱氨酸水平与中老年患者脑白质病变及认知功能障碍的相关研究[J]. 中国药物与临床202020(7):1103-1105.
Zhi HY Chen L Li B. Correlation between serum homocysteine level and white matter lesions and cognitive dysfunction in middle-aged and elderly patients[J]. Chin Remedies Clin202020(7):1103-1105.
39
彭思思,章军建. 血管性认知障碍的血液生物标志物研究进展[J]. 神经损伤与功能重建201712(5):423-426.
Peng SS Zhang JJ. Research progress on blood biomarkers of vascular cognitive impairment[J]. Neural Inj Funct Reconstr201712(5):423-426.
40
van Sloten TT Sedaghat S Carnethon MR,et al. Cerebral microvascular complications of type 2 diabetes:stroke,cognitive dysfunction,and depression[J]. Lancet Diabetes Endocrinol20208(4):325-336.
41
李 睿. 血尿酸与脑小血管病患者认知功能及脑白质病变的研究[D]. 石家庄:河北医科大学,2019.
Li R. Study on the relationship between serum uric acid and cognitive function in patients with cerebral small vessel disease and white matter lesions[D]. Shijiazhuang:Hebei Medical University,2019.
42
宋长城,张 婷,吕颖钺. 血尿酸水平与老年缺血性脑白质病变严重程度的相关性[J]. 中国临床研究201932(6):794-798.
Song CC Zhang T Lv YY. Relationship between serum uric acid level and severity of ischemic cerebral white matter lesion in elderly patients[J]. Chin J Clin Res201932(6):794-798.
43
王学颖,王洪权,赵伟丽. 脑小血管病患者认知功能障碍与血尿酸、同型半胱氨酸水平相关性研究[J]. 神经损伤与功能重建201914(7):360-361,373.
Wang XY Wang HQ Zhao WL. Correlation between cognitive dysfunction and serum uric acid and homocysteine levels in patients with cerebral small vessel disease[J]. Neural Inj Funct Reconstr201914(7):360-361,373.
44
Maniwa K Yano S Sheikh AM,et al. Association between cystatin C gene polymorphism and the prevalence of white matter lesion in elderly healthy subjects[J]. Sci Rep202010(1):4688.
45
史肖锦,梁彩霞,赵 宾,等. 血清胱抑素C水平与脑白质病变严重程度的相关性研究[J]. 蚌埠医学院学报202146(8):1011-1013.
Shi XJ Liang CX Zhao B,et al. Study on the correlation between serum level of cystatin C and severity of white matter lesions[J]. J Bengbu Med Coll202146(8):1011-1013.
46
Fandler-Höfler S Enzinger C Kneihsl M,et al. Early renal dysfunction and fibroblast growth factor-23 in patients with small vessel disease-related stroke[J]. Sci Rep20199(1):15410.
47
卢丽波,赵延欣. 血清胱抑素C水平与脑白质病变的相关性研究[J]. 同济大学学报(医学版)201940(2):235-239.
Lu LB Zhao YX. Study on the correlation between Cystatin C and white matter lesions[J]. J Tongji Univ Med Sci201940(2):235-239.
48
吕雅静,孙 虹,赵娇,等. 老年缺血性脑白质病变患者严重程度与血清胱抑素C的关系[J]. 中华老年心脑血管病杂志201719(1):63-66.
YJ Sun H Zhao J,et al. Relationship between white matter ischemic lesion severity and serum cystatin C level in very old patients[J]. Chin J Geriatr Heart Brain Vessel Dis201719(1):63-66.
49
Benn M Emanuelsson F Tybjærg-Hansen A,et al. Impact of high glucose levels and glucose lowering on risk of ischaemic stroke:a Mendelian randomisation study and meta-analysis[J]. Diabetologia202164(7):1492-1503.
50
薛 慧,彭小妍,程 程,等. 老年2型糖尿病患者缺血性脑白质病变严重程度的危险因素分析[J]. 中国实用神经疾病杂志202124(13):1140-1146.
Xue H Peng XY Cheng C,et al. Analysis of relevant risk factors of severity of white matter ischemic lesions in elderly patients with type 2 diabetes mellitus[J]. Chin J Pract Nerv Dis202124(13):1140-1146.
51
Hayden MR. Type 2 diabetes mellitus increases the risk of late-onset Alzheimer’s disease:ultrastructural remodeling of the neurovascular unit and diabetic gliopathy[J]. Brain Sci20199(10):262.
52
Moroni F Ammirati E Hainsworth AH,et al. Association of white matter hyperintensities and cardiovascular disease:the importance of microcirculatory disease[J]. Circ Cardiovasc Imaging202013(8):e010460.
53
Wong SM Jansen JFA Zhang CE,et al. Blood-brain barrier impairment and hypoperfusion are linked in cerebral small vessel disease[J]. Neurology201992(15):1669-1677.
54
王 萍,唐 敏,夏仕勇,等. 高龄糖尿病患者缺血性脑白质病变严重程度及其危险因素分析[J]. 中华老年心脑血管病杂志202022(2):197-199.
Wang P Tang M Xia SY,et al. Analysis of severity and risk factors of ischemic leukoencephalopathy in elderly diabetic patients[J]. Chin J Geriatr Heart Brain Vessel Dis202022(2):197-199.
55
方 波,程 燕,钟平. 血清血脂和胆红素水平与脑白质病变的相关性研究[J]. 临床神经病学杂志202033(3):186-190.
Fang B Cheng Y Zhong P. Study on the correlation of serum lipids and bilirubin with white matter lesion[J]. J Clin Neurol202033(3):186-190.
56
杨 光. 肾功能、血脂和同型半胱氨酸水平与帕金森病及其脑白质病变的相关性[D]. 合肥:安徽医科大学,2021.
Yang G. Correlation of renal function,blood lipids and homocysteine levels with Parkinson’s disease and white matter lesions[D]. Hefei:Anhui Medical University,2021.
57
Keeney JT Swomley AM Förster S,et al. Apolipoprotein A-I:insights from redox proteomics for its role in neurodegeneration[J]. Proteomics Clin Appl20137(1/2):109-122.
58
Tully PJ Yano Y Launer LJ,et al. Association between blood pressure variability and cerebral small-vessel disease:a systematic review and meta-analysis[J]. J Am Heart Assoc20209(1):e013841.
59
van Middelaar T Richard E Moll van Charante EP,et al. Visit-to-visit blood pressure variability and progression of white matter hyperintensities among older people with hypertension[J]. J Am Med Dir Assoc201920(9):1175-1177.
60
Liu ZD Zhao YX Zhang H,et al. Excessive variability in systolic blood pressure that is self-measured at home exacerbates the progression of brain white matter lesions and cognitive impairment in the oldest old[J]. Hypertens Res201639(4):245-253.
61
Cecchi E Giglioli C Valente S,et al. Role of hemodynamic shear stress in cardiovascular disease[J]. Atherosclerosis2011214(2):249-256.
62
Ma Y Song A Viswanathan A,et al. Blood pressure variability and cerebral small vessel disease:a systematic review and meta-analysis of population-based cohorts[J]. Stroke202051(1):82-89.
63
Brickman AM Reitz C Luchsinger JA,et al. Long-term blood pressure fluctuation and cerebrovascular disease in an elderly cohort[J]. Arch Neurol201067(5):564-569.

Comments

PDF(593 KB)

Accesses

Citation

Detail

Sections
Recommended

/