Evidence map›Paper›PMID 42284535›Full record

ArticleNeurology2026

Race and Ethnicity, Hypertension, and Neuroimaging Markers of Brain Aging: A Causal Mediation Analysis in the HABS-HD Study.

Michelle Caunca, Sirena Gutierrez, Koral Wheeler, Meredith N Braskie, Jacqueline Torres, Kristine Yaffe

Abstract read
In one paragraph

Article in Neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michelle CauncaDepartment of Neurology, University of California, San Francisco.
Sirena GutierrezDepartment of Epidemiology and Biostatistics, University of California, San Francisco.ORCID 0000-0001-9201-698X
Koral WheelerMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey; and.
Meredith N BraskieMark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina Del Rey; and.
Jacqueline TorresDepartment of Epidemiology and Biostatistics, University of California, San Francisco.ORCID 0000-0002-1579-6107
Kristine YaffeDepartment of Neurology, University of California, San Francisco.ORCID 0000-0003-0919-3825

Funding

NINDS Research Education Programs for Residents and Fellows in Neurology, Neurosurgery, Neuropathology, Neuroradiology and Emergency Medicine (R25)UE5NS070680 · NINDS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Scott Andrew Josephson · 2024 to 2026
$2.6M
NINDS NIH HHS UE5 NS070680
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe mechanisms underlying racial/ethnic differences in dementia incidence and pathology are multifactorial, and hypertension represents an actionable target for reducing these differences. We aimed to estimate the extent to which controlling for hypertension mediates racial/ethnic inequities in neuroimaging markers of brain aging.

methodsThe Health and Aging Brain Study-Health Disparities cohort is a highly phenotyped, racially and ethnically diverse cohort of cognitive aging. We used marginal structural models with inverse probability weights to estimate total and controlled direct effects of race/ethnicity, hypertension, and systolic blood pressure (SBP) at baseline, with neuroimaging markers measured on average 2 years later. Neuroimaging markers of brain aging were measured at the 2-year follow-up.

resultsAmong Black and Hispanic participants with any neuroimaging data at the second visit (overall N = 1,347), 68% and 71% were women, 75% and 67% had hypertension, and the mean age was 61 and 63 years, respectively. Black and Hispanic participants had greater white matter hyperintensity volume (WMHV) compared with non-Hispanic White (NHW) participants (n = 1,333, β [95% CI]: Black 2.08 [1.68-2.59], Hispanic 0.99 [0.91-1.08]). After analytically setting hypertension status to absent, Black-NHW inequities in WMHV were attenuated (β [95% CI]: 1.3 [1.01-1.65]). Black participants had lower amyloid deposition compared with NHW participants (n = 679, β [95% CI]: -0.29 [-0.46 to -0.12]), but analytically controlling for hypertension did not appreciably change estimates. Compared with NHW participants, Hispanic participants had lower Alzheimer disease meta-region of interest cortical thickness (n = 1,005, β [95% CI]: -0.20 [-0.34 to -0.07]), but neither hypertension nor SBP significantly mediated this difference. Medial temporal lobe tau-PET standardized uptake value ratio did not significantly differ in Black or Hispanic participants compared with NHW participants (n = 408). DISCUSSION: Black-NHW inequities in subclinical cerebral small vessel disease may be mitigated by population-level efforts to reduce hypertension prevalence. Future studies should extend this work to examine clinical outcomes.

Indexed as

AgingBrainHypertensionAgedBlack or African AmericanCohort StudiesFemaleHispanic or LatinoHumansMagnetic Resonance ImagingMaleMediation AnalysisMiddle AgedNeuroimagingWhiteWhite Matter

Identifiers

PMID42284535
PMCPMC13312934

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.