Visit‐to‐visit blood pressure variability in mild cognitive impairment: A possible marker of Alzheimer's disease in the SPRINT study?

Nagai, Michiaki; Kato, Masaya; Dote, Keigo

doi:10.1111/jch.14388

Cited by 4 publications

(4 citation statements)

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“…Findings suggest elevated BPV over a period of a few minutes is associated with plasma AD biomarker levels in a sample of community-dwelling older adults, independent of average BP levels. Results are consistent with growing evidence that BPV may be a useful marker of vascular dysfunction related to AD [5][6][7][8][9][10]15,[19][20][21][24][25][26][27][28] . Findings add to previous studies on BPV using CSF 21 and PET 20 AD biomarkers.…”

Section: Discussionsupporting

confidence: 88%

“…Both high and low blood pressure (BP) are associated with Alzheimer's disease (AD) dementia risk and pathology 1,2 , and even small improvements in BP control may have the potential to minimize deleterious health outcomes on a world-wide scale 3,4 . Beyond modifying average BP levels, there has been recent interest in BP variability (BPV) as a risk factor for dementia, in part due to BP's highly variable nature and its potential therapeutic implications [5][6][7][8] . Emerging evidence suggests elevated BPV over the longer term (e.g., over months to years or "visit-to-visit" BPV) and shorter term (e.g., over minutes, days) is associated with cognitive impairment and decline 8 , incidence and progression of dementia, including AD and vascular dementia 7,[9][10][11][12] , cerebrovascular disease [13][14][15] , stroke 16,17 , and AD pathology 18 , independent of average BP levels 8 .…”

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confidence: 99%

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Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

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Jang

et al. 2022

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Blood pressure variability is an emerging risk factor for Alzheimer’s disease in older adults, independent of average blood pressure levels. Growing evidence suggests increased blood pressure variability is linked to Alzheimer’s disease pathophysiology indexed by cerebrospinal fluid and positron emission tomography markers, but relationships with plasma Alzheimer’s disease markers have not been investigated. In this cross-sectional study of 54 community-dwelling older adults (aged 55–88, mean age 69.9 [8.2 SD]), elevated blood pressure variability over 5 min was associated with lower levels of plasma Aβ1–42 (standardized ß = − 0.36 [95% CI − 0.61, − 0.12]; p = 0.005; adjusted R2 = 0.28) and Aβ1–42: Aβ1–40 ratio (ß = − 0.49 [95% CI − 0.71, − 0.22]; p < 0.001; adjusted R2 = 0.28), and higher levels of total tau (ß = 0.27 [95% CI 0.01, 0.54]; p = 0.04; adjusted R2 = 0.19) and Ptau181:Aβ1–42 ratio (ß = 0.26 [95% CI 0.02, 0.51]; p = 0.04; adjusted R2 = 0.22). Findings suggest higher blood pressure variability is linked to plasma biomarkers of increased Alzheimer’s disease pathophysiology.

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Section: Discussionsupporting

confidence: 88%

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confidence: 99%

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

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Yew

Jang

et al. 2022

Sci Rep

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“…MCI is a transition phase between healthy cognition and dementia [ 56 ]. There are two subtypes of MCI.…”

Section: The Impact Of Blood Pressure Variability On Cognition In Mil...mentioning

confidence: 99%

“…One is amnestic MCI, which progresses to Alzheimer's disease preferentially. The other one is the multiple domains MCI, which progresses to different types of dementia, including Alzheimer's disease and vascular dementia [56]. Long-term SBPV was elevated in amnestic MCI compared to age-matched cognitively normal participants [57].…”

Section: The Impact Of Blood Pressure Variability On Cognition In Mil...mentioning

confidence: 99%

The impact of blood pressure variability on cognition: current limitations and new advances

Sun

2023

Journal of Hypertension

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Dementia is the most common neurodegenerative disease in the aging population. Emerging evidence indicates that blood pressure (BP) variability is correlated with cognitive impairment and dementia independent of mean BP levels. The state-of-the-art review summarizes the latest evidence regarding the impact of BP variability on cognition in cognitively intact populations, patients with mild cognitive impairment, and different dementia types, focusing on the important confounding factors and new advances. This review also summarizes the potential mechanisms underlying the relationship between BP variability and cognitive impairment, and dementia, briefly discussing sex differences in the relationship. At last, current limitations and future perspectives are discussed to optimize BP management in preventing cognitive impairment and dementia.

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Older Adults With Higher Blood Pressure Variability Exhibit Cerebrovascular Reactivity Deficits

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Jang

Dutt

et al. 2022

American Journal of Hypertension

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Background Elevated blood pressure variability is predictive of increased risk for stroke, cerebrovascular disease, and other vascular brain injuries, independent of traditionally studied average blood pressure levels. However, no studies to date have evaluated whether blood pressure variability is related to diminished cerebrovascular reactivity, which may represent an early marker of cerebrovascular dysfunction presaging vascular brain injury. Methods The present study investigated blood pressure variability and cerebrovascular reactivity in a sample of 41 community-dwelling older adults (mean age 69.6 [SD 8.7] years) without history of dementia or stroke. Short-term blood pressure variability was determined from blood pressure measurements collected continuously during a 5-minute resting period followed by cerebrovascular reactivity during 5-minute hypocapnia and hypercapnia challenge induced by visually guided breathing conditions. Cerebrovascular reactivity was quantified as percent change in cerebral perfusion by pseudo-continuous arterial spin labelling (pCASL)-MRI per unit change in end-tidal CO2. Results Elevated systolic blood pressure variability was related to lower whole brain cerebrovascular reactivity during hypocapnia (ß = -.43 [95% CI -.73, -.12]; p = .008; adjusted R2 = .11) and hypercapnia (ß = -.42 [95% CI -.77, -.06]; p = .02; adjusted R2 = .19). Conclusions Findings add to prior work linking blood pressure variability and cerebrovascular disease burden and suggest blood pressure variability may also be related to prodromal markers of cerebrovascular dysfunction and disease, with potential therapeutic implications.

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Visit‐to‐visit blood pressure variability in mild cognitive impairment: A possible marker of Alzheimer's disease in the SPRINT study?

Cited by 4 publications

References 31 publications

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

The impact of blood pressure variability on cognition: current limitations and new advances

Older Adults With Higher Blood Pressure Variability Exhibit Cerebrovascular Reactivity Deficits

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