title: Blood pressure decrease correlates with tau pathology and memory decline in hypertensive elderly.
abstract: In hypertension (HTN), cerebral blood flow regulation limits are changed, and the threshold for blood pressure (BP) at which perfusion is safely maintained is higher. This shift may increase the brain's vulnerability to lower BP in subjects with vascular disease. We investigated whether longitudinal reduction in mean arterial pressure (MAP) was related to changes in cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease in a group of cognitively healthy elderly with and without HTN. The relationships among MAP, memory decline, and hippocampal atrophy were also examined. Seventy-seven subjects (age 63.4 ± 9.4, range 44-86 years; education 16.9 ± 2.1, range 10-22 years; 60% women) were assessed twice, 2 ± 0.5 years apart. At both time points, all subjects underwent full medical and neuropsychological evaluations, lumbar punctures, and magnetic resonance imaging examinations. Twenty-five subjects had HTN. Hyper- and normotensive subjects did not differ in their CSF biomarkers, hippocampal volumes (HipVs), or memory scores at baseline. In the entire study group, the increase in tau phosphorylated at threonine 181 (p-tau(181)) was associated with a decline in verbal episodic memory (β = -0.30, p = 0.01) and HipV reduction (β = -0.27, p = 0.02). However, longitudinal decrease in MAP was related to memory decline (β = 0.50, p = 0.01) and an increase in p-tau(181) (β = -0.50, p = 0.01) only in subjects with HTN. Our findings suggest that the hypertensive group may be sensitive to BP reductions.
authors: Department of Psychiatry, Center for Brain Health, New York University School of Medicine, New York, NY, USA; Department of Radiology, New York University School of Medicine, New York, NY, USA. Electronic address: lidia.glodzik@nyumc.org.
authors: Lidia
authors: L
authors: Glodzik
authors: Henry
authors: H
authors: Rusinek
authors: Elizabeth
authors: E
authors: Pirraglia
authors: Pauline
authors: P
authors: McHugh
authors: Wai
authors: W
authors: Tsui
authors: Schantel
authors: S
authors: Williams
authors: Megan
authors: M
authors: Cummings
authors: Yi
authors: Y
authors: Li
authors: Kenneth
authors: K
authors: Rich
authors: Catherine
authors: C
authors: Randall
authors: Lisa
authors: L
authors: Mosconi
authors: Ricardo
authors: R
authors: Osorio
authors: John
authors: J
authors: Murray
authors: Henrik
authors: H
authors: Zetterberg
authors: Kaj
authors: K
authors: Blennow
authors: Mony
authors: M
authors: de Leon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000494:pharmacology; D001284:Atrophy; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology*; D002560:Cerebrovascular Circulation; D000075202:Contraindications; D005260:Female; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000378:metabolism; D061212:Memory, Episodic; D008875:Middle Aged; D010766:Phosphorylation; D012720:Severity of Illness Index; D016875:tau Proteins / Q000134:cerebrospinal fluid* / Q000378:metabolism
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D016875:tau Proteins
keywords: CSF biomarkers; Cognition; Low blood pressure
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