Hypertension is associated with worse cognitive function and hippocampal hypometabolism in Alzheimer's disease

Abstract

Although hypertension is associated with worse cognitive function, behavioural symptoms and hippocampal glucose hypometabolism, it is not associated with evidence of increased amyloid or tau pathology. Effective management of hypertension may potentially have a therapeutic role in the alleviation of symptoms in AD.

Magnetic resonance imaging in Alzheimer’s disease and mild cognitive impairment

“…MCI is notable for frontal and temporal GM loss, and atrophy in the primary olfactory cortex and some basal forebrain cholinergic system structures [19, 20, 22]. No volumetric differences were found between AD patients with and without hypertension [25]. …”

Applications of amyloid, tau, and neuroinflammation PET imaging to Alzheimer's disease and mild cognitive impairment

“…Degree of tracer binding or uptake is used to quantify neuropathology. Characteristic region-based patterns of brain hypometabolism have been established within a range of different dementia aetiologies (Kato, Inui, Nakamura, & Ito, 2016;Minoshima, Frey, Koeppe, Foster, & Kuhl, 1995;Moonga et al, 2017;Mosconi et al, 2008;Nestor, Caine, Fryer, Clarke, & Hodges, 2003). PET biomarkers that have been recommended to improve diagnostic accuracy for AD and MCI include decreased cerebral metabolism on [ 18 F]fludeoxyglucose (FDG) PET and increased Aβ deposition on amyloid PET (Albert et al, 2011;McKhann et al, 2011).…”

“…Rates of cerebral metabolism do not explicitly elucidate potential disease-causing neuropathology, but more likely highlight the degree of neuronal activity (Marcus, Mena, & Subramaniam, 2014). Characteristic region-based patterns of brain hypometabolism have been established within a range of different dementia aetiologies (Kato, Inui, Nakamura, & Ito, 2016;Minoshima, Frey, Koeppe, Foster, & Kuhl, 1995;Moonga et al, 2017;Mosconi et al, 2008;Nestor, Caine, Fryer, Clarke, & Hodges, 2003). PET tracers that measure Aβ burden, tau aggregation, and neuroinflammation provide remarkable insight directly into the processes underlying the pathophysiology of AD and MCI; however, the latter two have not yet been suggested for use in clinical practice.…”

Progress in neurology 2017–2018

“…Neurodegenerative diseases in general and the dementias and Alzheimer disease specifically are among the most common problems facing clinicians . It is of interest that some have suggested that the incidence of dementia is in decline as a result of improved treatment of vascular risk factors, although this observation remains in debate.…”

“…It is of interest that some have suggested that the incidence of dementia is in decline as a result of improved treatment of vascular risk factors, although this observation remains in debate. Hypertension has been shown to be associated with worse cognitive function, behavioural symptoms and hippocampal glucose hypometabolism, but not with increased amyloid or tau pathology . Mortality from Alzheimer disease is increasing in the European Union .…”