Cited by 112Dementia and Cognitive Impairment ResearchBlood Pressure and Hypertension StudiesCardiovascular Health and Disease Prevention

The DOI matches its Crossref record; 37 of the 38 references it cites were found in a registry or an index.

Late-life blood pressure association with cerebrovascular and Alzheimer disease pathology

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Abstract

Objective To examine associations of average and change in late-life blood pressure (BP) with cerebrovascular and Alzheimer disease (AD) neuropathology in a large group of decedents followed longitudinally in vivo. Methods This clinical-pathologic study was derived from prospective, community-based cohort studies of aging with similar design and data collection. Measurements of systolic BP (SBP) and diastolic BP (DBP) were obtained annually (mean follow-up 8 years, SD = 4.8). Postmortem neuropathologic evaluations documented diseases of aging. Using regression analyses, we examined associations of average and decline in late-life SBP, and separately in DBP, with neuropathology. Results In 1,288 persons (mean age at death = 88.6 years; 65% women), the mean standardized person-specific SBP across the study was 134 (SD = 13) and DBP was 71 (SD = 8) mm Hg. The odds of brain infarcts were increased for participants with a higher mean SBP. Specifically, a person with a 1 SD SBP above the mean (147 vs 134 mm Hg) would have a 46% increased odds of having one or more infarcts, and an increased odds of gross infarct (46%) and microinfarct (36%). Furthermore, a more rapidly declining SBP slope over time increased the odds of one or more infarcts. Mean DBP, not slope, was related to brain infarcts. AD pathology analyses showed an association of a higher mean SBP with higher number of tangles (p = 0.038) but not plaques or other pathology (all p > 0.06). Changes in BP were not significantly related to AD pathology. Conclusions Higher average late-life SBP and DBP, and independently a faster decline in SBP, are associated with increasing number of brain infarcts, including gross and microinfarcts. We found some evidence for a relation of SBP with AD, specifically tangles. Both average and decline in BP are related to brain disease.

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Metadata

Authors
Arvanitakis, Z., Capuano, A. W., Lamar, M., Shah, R. C., Barnes, L. L., Bennett, D. A., & Schneider, J. A.
Affiliations
Rush University Medical Center (US)
Venue
Neurology
Published
2018-08-07
Volume
91
Issue
6
Pages
e517-e525
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
OpenAlex
W2873977728
Cited by
112
References
38
Citations by year
2026: 3 · 2025: 12 · 2024: 14 · 2023: 9 · 2022: 17 · 2021: 18 · 2020: 19 · 2019: 17 · 2018: 3
FWCI
11.21
Type
journal article
Language
en
Open access
Locations
  • Neurology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Aging (R01AG017917, RF1AG022018, R01AG015819, P30AG010161, R01AG040039, RF1AG015819, R01AG022018)
  • National Institute of Neurological Disorders and Stroke (UH3NS100599, R01NS084965, UH2NS100599, UF1NS100599)
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
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
systolic blood pressure, diastolic blood pressure, blood pressure reduction, Alzheimer disease pathology, cerebrovascular pathology, cerebral infarction, microinfarcts, neurofibrillary tangles, aging, postmortem neuropathology
MeSH terms
Age Factors, Aged, Aged, 80 and over, Alzheimer Disease, Blood Pressure, Brain, Cerebrovascular Disorders, Female, Follow-Up Studies, Humans, Hypertension, Male, Prospective Studies, Risk Factors, Cohort Studies

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