Managing High Blood Pressure Important for Managing MS, Study Suggests

An association between high blood pressure and reduction of brain integrity in multiple sclerosis (MS) patients highlights the importance of blood pressure management by MS healthcare providers.

The severity of MS varies greatly. Although this is still poorly understood, certain factors, such as obesity and high blood pressure, are suspected of playing important roles. Understanding the link between such factors and disease progression could help improve disease management.

In the study “Effects of Systolic Blood Pressure on Brain Integrity in Multiple Sclerosis,” recently published in the journal Frontiers in Neurology, researchers tried to shed light on the association between high blood pressure (hypertension) and structural brain changes in MS patients.

The study involved 95 patients with relapsing-remitting MS (RRMS) with a median age of 32 (range 19-66) years. Patients had their blood pressure measured at the time of enrollment in the study. Brain MRI images were acquired and used to analyze brain volume and lesions. Statistical data then was used to look at the association between blood pressure and brain injury.

Twenty-eight patients (29%) had normal blood pressure measurements (systolic blood pressure, SBP, less than 120, and diastolic blood pressure, DBP, less than 80). Patients with SBP between 120 and 139 and DBP between 80 and 89 were defined as pre-hypertensive, and those with SBP above 140 and DBP above 90 were defined as hypertensive. Using these criteria, 50 patients (53%) had pre-hypertension and 17 (18%) had hypertension.

High levels of SBP were associated with a reduced integrity of the part of the brain known as white matter and a reduction in brain size (brain atrophy) in frontal areas. Furthermore, white matter areas that were affected by high blood pressure contributed to the the degree of disability.

Neither brain lesion volume nor the number of lesions were associated with SBP.

One of the limitations of this study is that it did not compare the results observed in MS patients with readings from healthy control participants. Nonetheless, according to the team, the study “shows that prehypertension and hypertension are common among patients with MS. Moreover, elevated BP is associated with reduced brain integrity.”

The significance and wider implications of these findings is that they “suggest the importance of aggressive, early management of hypertension as a preventive strategy, not only for cardiovascular and cerebrovascular events, but also potentially, to limit MS disease progression,” the researchers concluded.