Increasing MRI evidence of cerebral small-vessel disease is associated with worsening cognition in patients with hypertension, according to findings from a longitudinal study.

“Five out of 10 patients with hypertension experience a progression of brain vascular lesions — and especially white matter hyper-intensities (WMH) — despite being treated with blood pressure-lowering drugs,” said Dr Joan Jimenez-Balado from Vall Hebron Research Institute, Universitat Autonoma de Barcelona, Spain.

“Moreover, we found that WMH are related to an increased risk of mild cognitive impairment (MCI) diagnosis, a prodromal dementia stage,” he said by email.

Key MRI markers of cerebral small-vessel disease include WMH, lacunar infarcts and cerebral microbleeds. These lesions can accumulate over time, but it remains unclear which markers, if any, contribute to the risk of cognitive impairment.