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White matter hyperintensities (WMH) on MRI are a frequent finding on brain imaging in elderly people. It is well established that the most important risk factors for the presence of these lesions are age and arterial hypertension.1 Little is known about the progression of these lesions, as all studies except one2 have been cross-sectional in design. Therefore, we assessed whether WMH progress over time and whether the progression is associated with blood pressure (BP) levels.
The study was part of a large population study among 3974 inhabitants of Amsterdam described elsewhere.3 From this baseline cohort, 787 subjects, randomly selected by strata of age and Mini-Mental State Examination (MMSE) results, were invited to participate in a follow-up study of cognitive function; 511 (65%) agreed to participate. For the MRI study, we randomly selected from the 511 subjects a subsample with a range of cognitive functions that included clinically normal and mildly to moderately demented responders, described earlier,4 of whom 59 subjects agreed to participate in the MRI study. Those who did not participate in the MRI study did not differ in age, educational level, or sex from those who participated. All subjects were asked to return each year for a follow-up MRI investigation. After 2 …
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