LAUSR

Key Points Question How is intensive vs standard blood pressure treatment associated with small vessel disease biomarkers, such as white matter lesions, fractional anisotropy, mean diffusivity, and cerebral blood flow? Findings In this post hoc analysis of a randomized clinical trial with 458 participants, intensive blood pressure treatment was associated with reduced progression of white matter lesions, notably in deep white matter tracts, and supported by corresponding changes in fractional anisotropy and mean diffusivity. Intensive blood pressure treatment was also associated with improved cerebral blood flow in the occipital lobe, parietal lobule, frontal gyrus, and cuneus. Meaning Findings suggest that intensive blood pressure treatment was associated with a slower increase of white matter lesions and improved cerebral blood flow in areas that may be vulnerable to hypertension.