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The Association Between Blood Pressure and Incident Alzheimer Disease: A Systematic Review and Meta-analysis
Open accessAbstract
BACKGROUND: Many epidemiologic studies have considered the association between blood pressure (BP) and Alzheimer disease, yet the relationship remains poorly understood. METHODS: In parallel with work on the AlzRisk online database (www.alzrisk.org), we conducted a systematic review to identify all epidemiologic studies meeting prespecified criteria reporting on the association between hypertension, systolic BP, or diastolic BP and incident Alzheimer disease. When possible, we computed summary measures using random-effects models and explored potential heterogeneity related to age at BP assessment. RESULTS: Eighteen studies reporting on 19 populations met the eligibility criteria. We computed summary relative risks (RR(Σ)) for 3 measures of BP: hypertension (RR(Σ) = 0.97 [95% confidence interval = 0.80-1.16]); a 10-mm Hg increase in systolic BP (RR(Σ) = 0.95 [0.91-1.00]); and a 10-mm Hg increase in diastolic BP (RR(Σ) = 0.94 [0.85-1.04]). We were unable to compute summary estimates for the association between categories of systolic or diastolic BP and Alzheimer disease; however, there did not appear to be a consistent pattern across studies. After stratifying on age at BP assessment, we found a suggestion of an inverse association between late-life hypertension and Alzheimer disease and a suggestion of an adverse association between midlife diastolic hypertension and Alzheimer disease. CONCLUSIONS: Based on existing epidemiologic research, we cannot determine whether there is a causal association between BP and Alzheimer disease. Selection bias and reverse causation may account for the suggested inverse association between late-life hypertension on Alzheimer disease, but, given the expected direction of these biases, they are less likely to account for the suggestion that midlife hypertension increases risk. We advocate continuing systematic review; the AlzRisk database entry on this topic (www.alzrisk.org), which was completed in parallel with this work, will be updated as new studies are published.
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“However, epidemiological evidence currently does not support a clear link between blood pressure and pure AD (3).”
From Oversimplification of Dementia Risk Reduction Messaging Is a Threat to Knowledge Translation in Dementia Prevention Research (2018) · cites this paper as [3]
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Metadata
- Authors
- Power, M. C., Weuve, J., Gagne, J. J., McQueen, M. B., Viswanathan, A., & Blacker, D.
- Affiliations
- Harvard University (US)
- Rush University Medical Center (US)
- Brigham and Women's Hospital (US)
- University of Colorado Boulder (US)
- Corresponding author
- Power, Melinda C.
- ORCID
- Venue
- Epidemiology
- Published
- 2011-09
- Volume
- 22
- Issue
- 5
- Pages
- 646-659
- ISSN
- 1044-3983 (ISSN-L)
- PMC
- PMC3640480
- OpenAlex
- W2026771136
- Cited by
- 213
- References
- 104
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 7 · 2023: 13 · 2022: 10 · 2021: 10 · 2020: 23 · 2019: 14 · 2018: 14 · 2017: 21 · 2016: 24 · 2015: 24 · 2014: 10 · 2013: 13 · 2012: 11
- FWCI
- 1.59
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (F31AG038233)
- National Institute of Environmental Health Sciences (T32ES007069)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD060726)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- blood pressure, Alzheimer's disease, hypertension, systolic blood pressure, diastolic blood pressure, midlife hypertension, reverse causality, selection bias
- MeSH terms
- Age Factors, Alzheimer Disease, Blood Pressure, Humans, Hypertension, Risk Factors, Odds Ratio
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