Supplemental Digital Content is available in the text. Elevated blood pressure (BP) level is one of the most consistently identified risk factors for silent brain disease. BP values obtained at the proximal segment of the aorta (central BP) are more directly involved than brachial BP in the pathogenesis of cardiovascular disease. However, the association between central BP and silent cerebrovascular disease has not been clearly established. Participants in the CABL (Cardiovascular Abnormalities and Brain Lesions) study (n=993; mean age, 71.7±9.3 years; 37.9% men) underwent 2-dimensional echocardiography, arterial wave reflection analysis for determination of central BPs, and brain magnetic resonance imaging. Central BPs were calculated from the radial pulse waveform. Subclinical silent cerebrovascular disease was defined as silent brain infarction and white matter hyperintensity volume. Both brachial (P=0.014) and central pulse pressure (P=0.026) were independently associated with silent brain infarctions after adjustment for clinical variables, but not adjusting for each other. None of the brachial BP values was associated with upper quartile of white matter hyperintensity volume in multivariable analysis. Both central systolic BP (P<0.001) and central pulse pressure (P<0.001) were significantly associated with upper quartile of white matter hyperintensity volume in multivariable analysis, even after adjustment for brachial BP. In a predominantly older population-based cohort, both brachial and central pulse pressure were independently associated with silent brain infarction. However, higher central systolic BP and central pulse pressure, but not brachial BP, were significantly associated with white matter hyperintensity volume.

中文翻译：

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老年人中心血压与亚临床脑血管病的关系

补充数字内容在文本中可用。升高的血压 (BP) 水平是最一致确定的无症状脑病的危险因素之一。在主动脉近端（中央血压）获得的血压值比肱动脉血压更直接地参与心血管疾病的发病机制。然而，中枢性血压与无症状脑血管病之间的关联尚未明确。CABL（心血管异常和脑损伤）研究的参与者（n=993；平均年龄，71.7±9.3 岁；37.9% 男性）接受了二维超声心动图、动脉波反射分析以确定中心血压和脑磁共振成像. 从径向脉搏波形计算中心血压。亚临床无症状脑血管病被定义为无症状脑梗塞和白质高信号体积。在调整临床变量后，肱动脉 (P=0.014) 和中心脉压 (P=0.026) 均与无症状脑梗塞独立相关，但不相互调整。在多变量分析中，没有一个肱动脉血压值与白质高信号量的上四分位数相关。在多变量分析中，中心收缩压（P<0.001）和中心脉压（P<0.001）与白质高信号体积的上四分位数显着相关，即使在调整肱动脉血压后也是如此。在以老年人群为主的队列中，肱动脉和中央脉压均与无症状脑梗塞独立相关。然而，