Less Alzheimer disease neuropathology in medicated hypertensive than nonhypertensive persons.
OBJECTIVE
To test the hypothesis that use of antihypertensive medication is associated with lower Alzheimer disease (AD) neuropathology.


METHODS
This was a postmortem study of 291 brains limited to those with normal neuropathology or with uncomplicated AD neuropathology (i.e., without other dementia-associated neuropathology) in persons with or without hypertension (HTN) who were and were not treated with antihypertensive medications. Neuritic plaque (NP) and neurofibrillary tangle (NFT) densities, quantified in selected brain regions according to the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathologic criteria, with additional cortical NP counts, yielded 24 neuropathologic regional measures or summaries. Medicated hypertension (HTN-med; n = 77), nonmedicated HTN (HTN-nomed; n = 42), and non-HTN (no-HTN; n = 172) groups were compared by analyses of variance.


RESULTS
The HTN-med group had significantly less neuropathology than the no-HTN group. The no-HTN group averaged over 50% higher mean NP and NFT ratings, and double the mean NP count, of the HTN-med group. The HTN-nomed group had significantly more neuropathology than the HTN-med group, but not significantly less than the no-HTN group.


CONCLUSIONS
There was substantially less Alzheimer disease (AD) neuropathology in the medicated hypertension group than the nonhypertensive group, which may reflect a salutary effect of antihypertensive medication against AD-associated neuropathology.
Hoffman
L B
LB
Department of Psychiatry, Mount Sinai School of Medicine, New York, USA. lisa.b.hoffman@mssm.edu
Schmeidler
J
J
Lesser
G T
GT
Beeri
M S
MS
Purohit
D P
DP
Grossman
H T
HT
Haroutunian
V
V
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000033:anatomy & histology / Q000473:pathology; D003704:Dementia / Q000473:pathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D016874:Neurofibrillary Tangles / Q000473:pathology; D058225:Plaque, Amyloid / Q000473:pathology; D012307:Risk Factors
D000959:Antihypertensive Agents