title: Interarm differences in systolic blood pressure and the risk of dementia and subclinical brain injury.
abstract: BACKGROUND
  This study examined whether interarm differences in systolic blood pressure (IDSBP) ≥10 mm Hg were associated with the risk of incident dementia and subclinical brain injury.
  
  
  METHODS
  Between 1992 and 1998, 2063 participants of the Framingham Heart Study underwent assessment of IDSBP with results related to the 10-year risk of incident dementia including clinically characterized Alzheimer's disease. Secondary outcomes included markers of subclinical brain injury on magnetic resonance imaging.
  
  
  RESULTS
  High IDSBP were associated with a greater risk of incident dementia (hazard ratio [HR] 1.92; 95% confidence interval [CI], 1.09-3.40) and Alzheimer's disease (HR, 2.32; 95% CI, 1.29-4.18), but only in those who carried an apolipoprotein E (APOE) ε4 allele. IDSBP also predicted lower total brain volumes and more prevalent silent brain infarcts in those who were APOE ε4 positive.
  
  
  CONCLUSIONS
  High IDSBP were associated with an increased risk of dementia, including clinical Alzheimer's disease, and subclinical brain injury in those who were APOE ε4 positive.
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA; Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia. Electronic address: matthewpase@gmail.com.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Pase
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA; Boston University School of Public Health, Boston, MA, USA.
authors.forename: Alexa
authors.initials: A
authors.lastname: Beiser
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA.
authors.forename: Hugo
authors.initials: H
authors.lastname: Aparicio
authors.affiliation: Department of Neurology, School of Medicine & Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California Davis, Sacramento, CA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: DeCarli
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Murabito
authors.affiliation: Boston University School of Medicine & Framingham Heart Study, Boston, MA, USA.
authors.forename: Sudha
authors.initials: S
authors.lastname: Seshadri
mesh_terms: D000368:Aged; D053327:Apolipoprotein E4 / Q000235:genetics; D001794:Blood Pressure; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology*; D015331:Cohort Studies; D003704:Dementia / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000235:genetics / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006579:Heterozygote; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D012044:Regression Analysis; D012306:Risk; D012307:Risk Factors
chemical_list: D053327:Apolipoprotein E4
keywords: ABI; Alzheimer's disease; Ankle-brachial index; Atherosclerosis; Blood pressure; Cerebrovascular disease; Dementia; Framingham Heart Study; Interarm differences in systolic blood pressure; Magnetic resonance imaging; Peripheral vascular disease