Relation of blood pressure to risk of incident Alzheimer's disease and change in global cognitive function in older persons.
OBJECTIVE
To examine the relation of systolic and diastolic blood pressure to incident Alzheimer's disease (AD) and rate of cognitive change.


METHODS
Longitudinal cohort study with annual clinical evaluations. At baseline, blood pressure was measured, apolipoprotein E (APOE) genotyping was performed, and medications were reviewed.


RESULTS
824 older Catholic clergy members without baseline dementia were recruited from across the United States. During a mean of about 6 years of observation, 151 persons developed AD. In a proportional hazards model adjusted for age, sex and education, neither systolic (relative risk = 0.995; 95% CI: 0.986, 1.004, p = 0.249) nor diastolic (relative risk = 1.000; 95% CI: 0.985, 1.015, p = 0.975) blood pressure was related to AD incidence. In mixed effects models, neither systolic nor diastolic blood pressure was related to level or to annual rate of change on a global measure of cognition. These results did not change in subsequent models that accounted for the use of medications with antihypertensive properties or for the possession of an APOE epsilon4 allele.


CONCLUSIONS
In a cohort of older persons with a majority taking medications with antihypertensive properties, we did not find a relationship between blood pressure and risk of AD or cognitive decline.
Shah
Raj C
RC
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA. Raj_C_Shah@rush.edu
Wilson
Robert S
RS
Bienias
Julia L
JL
Arvanitakis
Zoe
Z
Evans
Denis A
DA
Bennett
David A
DA
D000368:Aged / Q000523:psychology*; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000523:psychology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001057:Apolipoproteins E / Q000235:genetics; D001794:Blood Pressure / Q000502:physiology*; D002977:Clergy; D003071:Cognition / Q000502:physiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
D000959:Antihypertensive Agents; D001057:Apolipoproteins E