Self-reported late-life hypertension is associated with a healthy cognitive status and reduced Alzheimer’s disease pathology burden

Andrew Robinson, Tawfique Bin Rizwan, Yvonne Davidson, James Minshull, Phillip Tinkler, Antony Payton, David Mann, Federico Roncaroli

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Whilst mid-life hypertension represents a risk factor for the development of Alzheimer's disease (AD), the risk after the age of 65 is less certain. Establishing relationships between late life hypertension and the pathological changes of AD could be crucial in understanding the relevance of blood pressure as a risk factor for this disorder.
Objective
We investigated associations between self-reported late-life hypertension, cognitive status and AD pathology at death. The impact of antihypertensive medication was also examined.
Methods
Using the Cornell Medical Index questionnaire, we ascertained whether participants had ever reported hypertension. We also noted use of antihypertensive medication. The donated brains of 108 individuals were assessed for AD pathology using consensus guidelines. Statistical analysis aimed to elucidate relationships between hypertension and AD pathology.
Results
We found no associations between self-reported hypertension and cognitive impairment at death. However, those with hypertension were significantly more likely to exhibit lower levels of AD pathology as measured by Thal phase, Braak stage, CERAD score and NIA-AA criteria – even after controlling for sex, level of education and presence of APOE ε4 allele(s). No significant associations could be found when examining use of antihypertensive medications.
Conclusion
Our findings suggest that late-life hypertension is associated with less severe AD pathology. We postulate that AD pathology may be promoted by reduced cerebral blood flow.
Original languageEnglish
JournalJournal of Alzheimer's Disease
Publication statusAccepted/In press - 20 Feb 2024

Keywords

  • Alzheimer’s disease
  • Dementia
  • Neuropathology
  • Hypertension

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