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Brainstem network connectivity with mid-anterior insula predicts lower systolic blood pressure at rest in older adults with hypertension

Journal of Human Hypertension volume 35, pages 1098–1108 (2021)Cite this article

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Abstract

Central regulation of heart rate and blood pressure provides the bases for a neurogenic mechanism of hypertension (HTN). Post menopause (PM) age coincides with changes in resting state functional brain connectivity (rsFC) as well as increased risk for HTN. Whether the neural networks underpinning cardioautonomic control differ between PM women with and without HTN is unclear. Phenotypic and functional neuroimaging data from the Nathan Kline Institute was first evaluated for group differences in intrinsic network connectivity between 22 HTN post menopausal women and 22 normotensive controls. Intrinsic rsFC of the midbrain-brainstem-cerebellar network with bilateral mid-anterior insula was lower in women with HTN (FWE-corrected, p < 0.05). Z-scores indicating rsFC of these regions were extracted from the 44 PM women and a cohort of 111 adults, not presenting with metabolic or neurodegenerative disease, and compared to in-office systolic and diastolic blood pressure. Lower rsFC of the left (r  = −0.17, p = 0.019) and right (r  = −0.14, p = 0.048) mid-anterior insula with brainstem nuclei was associated with higher systolic blood pressure in the combined sample. The magnitude of this effect in men and women of post menopausal age supports a neurogenic mechanism for blood pressure regulation in older adults with HTN.

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Fig. 1: Intrinsic resting state networks (RSN).
Fig. 2: Between group comparison of IC09 (midbrain-cerebellar network).
Fig. 3: Scatter plot comparing systolic blood pressure (X-axis) and left insula connectivity with the midbrain-brainstem-cerebellar network.
Fig. 4: Scatter plot comparing diastolic blood pressure (X-axis) and right insula connectivity with the midbrain-brainstem-cerebellar network.

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RCM supported by K01-HL13972.

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  1. Department of Psychology, University of Miami, Coral Gables, FL, USA

    Roger C. McIntosh, Judith D. Lobo, Anting Yang & Neil Schneiderman

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McIntosh, R.C., Lobo, J.D., Yang, A. et al. Brainstem network connectivity with mid-anterior insula predicts lower systolic blood pressure at rest in older adults with hypertension. J Hum Hypertens 35, 1098–1108 (2021). https://doi.org/10.1038/s41371-020-00476-2

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