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Late-life blood pressure association with cerebrovascular and Alzheimer disease pathology
Open accessAbstract
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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“while vascular risk factors like higher blood pressure levels have been found associated with cerebral vessel disease including arteriolosclerosis [28,3]”
From Sex differences in Alzheimer’s disease and common neuropathologies of aging (2018) · cites this paper as [3]
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“A recent clinical-pathologic study showed that higher systolic blood pressure (147 vs. 134 mm Hg) increased the odds of having one or more brain infarcts by 46%, a gross infarct by 46%, and microinfarcts by 36%43.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [43]
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Association of Cardiovascular Health and Cognition
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Vascular risk factors and cerebrovascular pathologic changes on autopsy: The 90+ Study
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Cardiovascular risk and obesity impact loss of grey matter volume earlier in males than females
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Cerebrovascular Pathology and Cognitive Outcomes in Older Black Decedents
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Self-citationRelationship of antihypertensives with late‐life cognitive decline and neuropathology
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SPECT and PET in Vascular Dementia
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Effect Modifiers of the Association of Blood Pressure With Brain Amyloid and Tau Pathology
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Self-citationDementia Prevalence in the CARhES Cohort: Importance of Socioeconomic Level
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Hypertension acts together with Aβ pathology in late-life to promote memory loss
Ros, L. U. D., Ferrari‐Souza, J. P., Bastiani, M. A. D., Hauschild, L. A., Bellaver, B., Ferreira, P. C. L., Leffa, D. T., Povala, G., Lussier, F. Z., Chamoun, M., et al. (2026) · The Journal of Prevention of Alzheimer s Disease · doi:10.1016/j.tjpad.2026.100579 · Cited by 1
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Self-citation
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)
- ORCID
- Venue
- Neurology
- Published
- 2018-08-07
- Volume
- 91
- Issue
- 6
- Pages
- e517-e525
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC6105052
- 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
- bronze
- doi.org
- 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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