AUTHOR=Hayes Cellas A. , Vintimilla Raul , Chaudhuri Soumilee , Odden Michelle C. 

TITLE=Sex differences in the association of cardiometabolic risk scores and blood pressure measurements with white matter hyperintensities in diverse older adults—HABS-HD

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=Volume 17 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2025.1607646

DOI=10.3389/fnagi.2025.1607646

ISSN=1663-4365

ABSTRACT=IntroductionWe aimed to determine whether cardiometabolic risk factors and blood-pressure (BP) metrics were differentially associated with white matter hyperintensities volume (WMHV) in males versus females in the Health and Aging Brain Study–Health Disparities.MethodsWe analyzed 3,585 community-dwelling adults (2,207 females) from non-Hispanic White, non-Hispanic Black, and Hispanic groups who underwent BP measurement and WMHV quantification. Linear regression models assessed (i) individual risk factors (diabetes, hypertension, dyslipidemia, obesity, tobacco dependence), (ii) a composite risk score, and (iii) four BP metrics (systolic, diastolic, pulse pressure, mean arterial pressure), each including a sex-interaction term and adjusting for age, education, race/ethnicity, and scanner. A second BP model also controlled for all five risk factors.ResultsDiabetes (β = 0.46, 95% CI 0.28–0.64), hypertension (β = 0.47, 0.30–0.64), and higher composite risk (β = 0.19, 0.12–0.26) were associated with greater WMHV. Diastolic BP (β = 0.18, 0.11–0.26) and mean arterial pressure (β = 0.14, 0.07–0.21) related to larger WMHV, with diastolic BP remaining significant after full adjustment (β = 0.14, 0.07–0.22). No sex interactions survived correction.DiscussionThese findings underscore the importance of aggressive cardiometabolic and BP control, particularly diastolic BP, to mitigate WMHV in both sexes.