In this meta-analysis involving data from 31,250 participants aged 60 years and older (average age 72 years), researchers sought to examine whether previous HTN or antihypertensive use alters AD or non-AD risk in late life and the ideal blood pressure (BP) for risk reduction in a diverse consortium of cohort studies.
The authors wrote, “Previous randomized controlled trials and longitudinal studies have indicated that ongoing antihypertensive use in late life reduces all-cause dementia risk, but the specific impact on AD and non-AD risk remains unclear.”
This meta-analysis employed individual participant data from community-based longitudinal aging studies within a consortium and assessed the risk of developing AD and non-AD dementia, concentrating on HTN history, antihypertensive use, and baseline systolic/diastolic BP. The primary outcomes were AD and non-AD dementia.
For each participant, researchers examined BP measurements, HTN diagnosis, and the use of antihypertensive medications and discovered that 9% had untreated HTN, 51% were taking antihypertensive medications, 36% did not have HTN, and 4% were noted as uncertain.
The mean follow-up period was 4.2 years, during which BP measurements, HTN diagnoses, and antihypertensive medication use were documented. The results revealed that after adjusting for factors such as age, gender, and education, patients with untreated HTN had a 36% augmented risk of AD compared with patients without HTN and a 42% increased risk of AD compared with patients with HTN who were taking medications. Moreover, 1,415 participants developed AD and 681 developed non-AD dementia.
In contrast, patients with treated HTN did not display an elevated risk for AD compared with healthy controls (hazard ratio [HR], 0.961; P = .6644). However, patients with both treated (HR, 1.285; P = .027) and untreated (HR, 1.693; P = .003) HTN had an augmented risk for non-AD dementia compared with healthy controls, and the risk for non-AD dementia was comparable for patients with treated and untreated HTN.
The authors concluded that the use of antihypertensive medication was associated with a decreased risk of AD but not non-AD dementia in late life, which emphasizes the significance of managing HTN to lower AD risk.
The authors wrote, “A single measure of BP was not associated with AD risk, but diastolic BP may have a U-shaped relationship with non-AD risk over longer periods in late life.”
Study author Matthew J. Lennon, MD, PhD, of the University of New South Wales in Australia, stated, “High blood pressure is a leading cause of stroke and cerebrovascular disease, and yet it can be controlled with medication, reducing a person’s risk of these diseases.”
Dr. Lennon added, “Taking blood pressure medications has also been found in previous research to reduce a person’s risk of dementias overall, but less is known about how blood pressure affects a person’s risk of Alzheimer’s disease. Our meta-analysis looked at older people and found that not treating blood pressure may indeed increase a person’s risk.”
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