Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study

Gabin, Jessica Mira; Tambs, Kristian; Saltvedt, Ingvild; Sund, Erik R.; Holmen, Jostein

doi:10.1186/s13195-017-0262-x

Cited by 74 publications

(60 citation statements)

References 44 publications

(48 reference statements)

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“…37,38 However, this assumption is complicated by the fact that different studies will find opposing results when examining the same cardiometabolic abnormality. For instance, some studies have found that abdominal obesity, 11 hypertension, 39 and high lipids 11,35 are protective against risk of dementia. Other studies find that obesity, 40,41 hypertension, 42 diabetes, 43 and high lipids 44 are risk factors for incident dementia.…”

Section: Supporting Information Table B)mentioning

confidence: 99%

Risk of dementia associated with cardiometabolic abnormalities and depressive symptoms: a longitudinal cohort study using the English longitudinal study of ageing

Kontari

Smith

2018

Int J Geriat Psychiatry

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Objectives Depression and cardiometabolic abnormalities are independently associated with a high risk of dementia. This study aimed to examine the association of comorbid depressive symptoms and cardiometabolic abnormalities with risk of dementia. Methods The sample comprised 4859 participants aged 50 or older without baseline dementia who took part in the English Longitudinal Study of Ageing (waves 2‐7). Depressive symptoms were assessed using the Center for Epidemiologic Studies‐Depression tool. Cardiometabolic abnormalities were defined as three or more cardiometabolic risk factors (inflammation, central obesity, raised triglycerides, low high‐density lipoprotein [HDL] cholesterol, hypertension, and hyperglycaemia or diabetes). Participants were classified into four groups based on presence of depressive symptoms and cardiometabolic abnormalities. Results were analysed using the Cox proportional hazards regression adjusted for covariates. Results A total of 216 cases of incident dementia were reported over 10 years of follow‐up. The group with high depressive symptoms only had an increased hazard of developing incident dementia during follow‐up (HR = 2.68; 95%CI, 1.70‐4.23), which was attenuated after adjustment for baseline cognition. No evidence was found for an association of overall cardiometabolic abnormalities with incident dementia; though hyperglycaemia, hypertension, and abdominal obesity with depressive symptoms had an unadjusted association with incident dementia. Only low‐HDL cholesterol with depressive symptoms had an adjusted association with incident dementia (HR = 0.18; 95%CI, 0.04‐0.75). Conclusions This work confirms depressive symptoms as a risk factor for incident dementia. However, low HDL‐cholesterol with depressive symptoms may be protective against dementia, though more work is required to confirm this association.

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Section: Supporting Information Table B)mentioning

confidence: 99%

Risk of dementia associated with cardiometabolic abnormalities and depressive symptoms: a longitudinal cohort study using the English longitudinal study of ageing

Kontari

Smith

2018

Int J Geriat Psychiatry

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“…While the literature is inconsistent about the risk of AD associated with hypertension in individuals over age 60 (68–71), studies indicate that elevated systolic blood pressure (SBP) (≥ 160 mm Hg) in midlife is associated with an increased risk of eventual AD (68, 72, 73). Hypertension has also been associated with an increased risk of AD and cognitive decline in APOE ε4 carriers compared to non-carriers (74, 75).…”

Section: Ad Comorbidity Considerationsmentioning

confidence: 99%

Clinical Application of Apoe in Alzheimer’s Prevention: A Precision Medicine Approach

et al. 2018

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Population-attributable risk models estimate that up to one-third of Alzheimer’s disease (AD) cases may be preventable through risk factor modification. The field of AD prevention has largely focused on addressing these factors through universal risk reduction strategies for the general population. However, targeting these strategies in a clinical precision medicine fashion, including the use of genetic risk factors, allows for potentially greater impact on AD risk reduction. Apolipoprotein E (APOE), and specifically the APOE ε4 variant, is one of the most well-established genetic influencers on late-onset AD risk. In this review, we evaluate the impact of APOE ε4 carrier status on AD prevention interventions, including lifestyle, nutrigenomic, pharmacogenomic, AD comorbidities, and other biological and behavioral considerations. Using a clinical precision medicine strategy that incorporates APOE ε4 carrier status may provide a highly targeted and distinct approach to AD prevention with greater potential for success.

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“…Our ndings may indicate that this discrepancy is due to the different effects of SBP and DBP on dementia. Inverse associations of SBP with the risk of AD have been reported in large, population-based health studies [39], and recently supported by a Mendelian randomization study of AD [40]. Although SBP cannot fully represent su ciency of cerebral blood ow, SBP is negatively associated with AD incidence, which could suggest su cient cerebral oxygen levels follow insu cient cerebral blood ow.…”

Section: Discussionmentioning

confidence: 86%

Associations between vascular risk factors and subsequent Alzheimer’s disease in older adults

Lee

Kim

Lee

et al. 2020

Preprint

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Background: The clinical guidelines related to the primary prevention of Alzheimer’s disease (AD) have focused on the management of vascular risk factors. However, the link between vascular risk factors and AD in older adults remains unclear. This study aimed to determine the association between vascular risk factors and subsequent AD in 178,586 older adults (age: ≥65 years). Methods: Participants were recruited from 2009 through 2010 and followed up for 6 years. We assessed various vascular risk factors (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], triglycerides [TG], fasting glucose [FG], systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP] and body mass index [BMI]) and their association with AD incidence, categorizing each vascular factor using current clinical guidelines. Results: AD was observed in 6.0% of participants at follow-up. All lipid profiles (TC, LDL-C, HDL-C, TG) were positively associated with the risk of AD. SBP and PP were in negative associations with AD, and DBP was positively associated with AD. BMI exhibited a negative association with AD incidence. We found no significant association between FG and AD risk. The sex difference was observed to have effects on vascular risk factors.Conclusions: In this study, we comprehensively investigated the association between eight vascular risk factors and the risk of incident AD. Our findings suggest that multiple vascular risk factors are related to the development of AD in older adults. These results can help inform future guidelines for reducing AD risk.

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Association between blood pressure and Alzheimer disease measured up to 27 years prior to diagnosis: the HUNT Study

Cited by 74 publications

References 44 publications

Risk of dementia associated with cardiometabolic abnormalities and depressive symptoms: a longitudinal cohort study using the English longitudinal study of ageing

Risk of dementia associated with cardiometabolic abnormalities and depressive symptoms: a longitudinal cohort study using the English longitudinal study of ageing

Clinical Application of Apoe in Alzheimer’s Prevention: A Precision Medicine Approach

Associations between vascular risk factors and subsequent Alzheimer’s disease in older adults

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