Pulse pressure correlates with leukoaraiosis in Alzheimer disease

Lee, Ae Young; Jeong, Seong-Hae; Choi, Byung Hee; Sohn, Eun Hee; Chui, Helena C.

doi:10.1016/j.archger.2005.06.009

Cited by 22 publications

(20 citation statements)

References 30 publications

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“…These observed relationships are consistent with our previously published report demonstrating that vascular risk factors are associated with CVD in AD patients (20), as well as neuroimaging studies showing that increased vascular risk burden is associated with MRI markers of CVD (e.g., white matter hyperintensities) in mild cognitive impairment (25) and AD (26). Of the 84 participants in the present sample, 50 (59.5%) displayed CVC at autopsy whereas 34 (40.5%) did not.…”

Section: Discussionsupporting

confidence: 92%

Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy‐confirmed Alzheimer's disease

Bangen

Nation

Delano‐Wood

et al. 2014

Alzheimer's & Dementia

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We examined the relationships of ante-mortem vascular risk factors to post-mortem cerebrovascular and AD pathologies. Eighty-four AD patients underwent assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA] or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVC), individuals were excluded if autopsy revealed large stroke. The most common forms of CVC were circle of Willis atherosclerosis followed by arteriosclerosis, lacunes, and microinfarcts. Excluding history of TIA/clinical stroke, individual vascular risk factors were not associated with CVC. However, the presence of multiple vascular risk factors was associated with CVC. Further, presence of CVC was associated with lower Braak and Braak stage. Findings highlight the importance of aggregate risk in the vascular contribution to dementia. Interventions designed to maintain cerebrovascular health may represent important opportunities for preventing or delaying dementia, even when AD is the dominant pathology.

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Section: Discussionsupporting

confidence: 92%

Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy‐confirmed Alzheimer's disease

Bangen

Nation

Delano‐Wood

et al. 2014

Alzheimer's & Dementia

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“…Similar to the results of a nonlinear relationship between PP and cognitive performance in subjects aged 80 and older, a Korean study showed a significant association between PP and risk of AD, although with much smaller sample size. 28 An interesting finding not reported in the Korean study, but supported by published reports is a U-shaped relationship between PP and cognitive performance. 29 Higher and lower tertiles of PP were associated with poor cognitive performance in a sample of 256 patients with AD.…”

Section: Discussionmentioning

confidence: 74%

High Blood Pressure, Hypertension, and High Pulse Pressure Are Associated with Poorer Cognitive Function in Persons Aged 60 and Older: The Third National Health and Nutrition Examination Survey

Obisesan

Martins

et al. 2008

J American Geriatrics Society

139

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“…High PP in older adults is recognized as a marker of increased artery stiffness and widespread atherosclerosis [32], and may lead to decreased perfusion of the cerebral white matter and ultimately increase the risk for cognitive impairment as seen in some previous studies [21–23]. A U-shaped association between PP and cognitive impairment found in a previous study [20], was also found in GAMs, quadratic models and univariate logistic models, but not confirmed when logistic models were further performed in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, PP and cognitive function have not been extensively studied, with positive associations with cognitive impairment being reported in some [20–23] but not all [24] studies. Some studies suggest that MAP may be a more accurate predictor than other blood pressure indices [25, 26].…”

Section: Introductionmentioning

confidence: 99%

A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly

Zhu

Yin

et al. 2017

Journal of the American Medical Directors Association

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Objectives Higher or lower blood pressure may relate to cognitive impairment, while the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association. Design Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011 Setting Community-based setting in longevity areas in China Participants 7,144 Chinese elderly aged 65 years and older were included in the sample Measures Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP)-(DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE). Results Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP and MAP. The cut-points at which risk for cognitive impairment (MMSE<24) was minimized were determined by quadratic models as 141 mmHg, 85 mmHg, 62 mmHg and 103 mmHg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cut-points, each 1mmHg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cut-points, each 1mmHg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP and MAP, respectively. Conclusion A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment prevention.

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Pulse pressure correlates with leukoaraiosis in Alzheimer disease

Cited by 22 publications

References 30 publications

Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy‐confirmed Alzheimer's disease

Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy‐confirmed Alzheimer's disease

High Blood Pressure, Hypertension, and High Pulse Pressure Are Associated with Poorer Cognitive Function in Persons Aged 60 and Older: The Third National Health and Nutrition Examination Survey

A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly

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