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. 2020;77(4):1655-1669.
doi: 10.3233/JAD-200221.

Long-Term Blood Pressure Variability Across the Clinical and Biomarker Spectrum of Alzheimer's Disease

Isabel J Sible  1 , Daniel A Nation  2   3 ; Alzheimer’s Disease Neuroimaging Initiative
Affiliations

Long-Term Blood Pressure Variability Across the Clinical and Biomarker Spectrum of Alzheimer's Disease

Isabel J Sible et al. J Alzheimers Dis. 2020.

Abstract

Background: Elevated blood pressure is linked to cognitive impairment and Alzheimer's disease (AD) biomarker abnormality. However, blood pressure levels vary over time. Less is known about the role of long-term blood pressure variability in cognitive impairment and AD pathophysiology.

Objective: Determine whether long-term blood pressure variability is elevated across the clinical and biomarker spectrum of AD.

Methods: Alzheimer's Disease Neuroimaging Initiative participants (cognitively normal, mild cognitive impairment, AD [n = 1,421]) underwent baseline exam, including blood pressure measurement at 0, 6, and 12 months. A subset (n = 318) underwent baseline lumbar puncture to determine cerebrospinal fluid amyloid-β and phosphorylated tau levels. Clinical groups and biomarker-confirmed AD groups were compared on blood pressure variability over 12 months.

Results: Systolic blood pressure variability was elevated in clinically diagnosed AD dementia (VIM: F2,1195 = 6.657, p = 0.001, η2 = 0.01) compared to cognitively normal participants (p = 0.001), and in mild cognitive impairment relative to cognitively normal participants (p = 0.01). Findings were maintained in biomarker-confirmed AD (VIM: F2,850 = 5.216, p = 0.006, η2 = 0.01), such that systolic blood pressure variability was elevated in biomarker-confirmed dementia due to AD relative to cognitively normal participants (p = 0.005) and in biomarker-confirmed mild cognitive impairment due to AD compared to cognitively normal participants (p = 0.04).

Conclusion: Long-term systolic blood pressure variability is elevated in cognitive impairment due to AD. Blood pressure variability may represent an understudied aspect of vascular dysfunction in AD with potential clinical implications.

Keywords: Alzheimer’s disease; amyloid; blood pressure; cognitive dysfunction; tau proteins.

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Conflict of interest statement

CONFLICT OF INTEREST/DISCLOSURE STATEMENT

The authors have no conflict of interest to report.

Figures

Figure 1.
Figure 1.. Systolic BPV by Clinical Group
1a. Systolic BPV was greatest in clinically diagnosed AD overall and compared to CN for all measures of BPV. Clinically diagnosed MCI exhibited greater systolic BPV relative to CN on SD and VIM measures of BPV. 1b. Clinical groups did not significantly differ by diastolic BPV. Boxplot lines display minimum, 1st quartile, median, 3rd quartile, and maximum. Abbreviations: BPV = blood pressure variability; CN = cognitively normal; MCI = Mild Cognitive Impairment; AD = Alzheimer’s disease; SD = standard deviation; CV = coefficient of variation; VIM = variation independent of mean
Figure 2.
Figure 2.. Systolic BPV by Biomarker-Confirmed AD Group
2a. Systolic BPV was greatest in biomarker-confirmed dementia due to AD overall and compared to CN for all measures of BPV. Biomarker-confirmed MCI due to AD exhibited greater systolic BPV relative to CN as measured by VIM. 2b. Biomarker-confirmed AD groups did not significantly differ by diastolic BPV. Boxplot lines display minimum, 1st quartile, median, 3rd quartile, and maximum. Aβ+Ptau+ indicates positive biomarkers for both Aβ and Ptau. Abbreviations: BPV = blood pressure variability; Aβ = amyloid-β; Ptau = phosphorylated tau CN = cognitively normal; MCI = Mild Cognitive Impairment; AD = Alzheimer’s disease; SD = standard deviation; CV = coefficient of variation; VIM = variation independent of mean
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References

    1. Wilkie F, Eisdorfer C (1971) Intelligence and blood pressure in the aged. Science (80-. ) 172, 959–962. - PubMed
    1. Qiu C, Winblad B, Fratiglioni L (2005) The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurol. 4, 487–499. - PubMed
    1. Launer LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ (1995) The association between midlife blood pressure levels and late-life cognitive function: The Honolulu-Asia Aging study. JAMA J. Am. Med. Assoc 274, 1846–1851. - PubMed
    1. Kilander L, Nyman H, Boberg M, Hansson L, Lithell H (1998) Hypertension is related to cognitive impairment: A 20-year follow-up of 999 men. Hypertension 31, 780–787. - PubMed
    1. Kilander L (2000) The association between low diastolic blood pressure in middle age and cognitive function in old age. A population-based study. Age Ageing 29, 243–248. - PubMed

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