P3‐039: The relationship between blood pressure and incident Alzheimer's disease: A systematic review and meta‐analysis
Year: 2010
Type: article
Study designs: Systematic Review, Meta-Analysis
Abstract: A substantial number of epidemiologic studies have considered the association between blood pressure (BP) and Alzheimer disease (AD) yet the relationship is poorly understood. We conducted a systematic review of the literature to identify all epidemiologic studies meeting pre-specified criteria reporting on the association between systolic blood pressure (SBP), diastolic blood pressure (DBP), or hypertension and incident AD. We grouped association estimates by exposure definition and, where possible, computed summary measures using random-effects models. Fifteen studies reporting on 16 populations met the eligibility criteria. “History of hypertension” (summary relative risk [RRΣ] = 0.87, 95%CI: 0.72-1.04) and “hypertension at enrollment” (RRΣ = 0.96; 95%CI: 0.42-2.23) were not significantly associated with incident AD. SBP was inversely (albeit weakly) associated with incident AD (RRΣ per 10-mm Hg increment = 0.95, 95%CI: 0.91-1.00). Overall, DBP was not significantly associated with incident AD (RRΣ = 0.94, 95%CI: 0.86-1.04). We did not observe significant heterogeneity for any summary estimate, although these statistics are likely underpowered. Estimates of associations between categories of SBP or DBP and AD could not be pooled, and visual inspection of the reported associations failed to suggest an overarching pattern. The association between vascular risk factors and AD may vary with age. Stratification by age at BP assessment suggested that midlife, but not late-life diastolic hypertension may predict increased AD risk. However, only one reported association was statistically significant and we were unable to compute summary estimates given variation in the modeling of DBP. Although limited, the existing data do not support the hypothesis that other midlife or late-life measures of BP are associated with incident AD. Contrary to current hypotheses, little epidemiologic evidence exists to support an association between BP and incident AD. Selection effects and differential misclassification of AD may account for the overall null findings, given the known association between BP and cardiovascular mortality and use of BP in the differential diagnosis between AD and vascular dementia. The suggestion that midlife diastolic hypertension increases AD risk requires further confirmation, and a causal relationship will be difficult to establish given the known overlap between AD and vascular pathology.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2133679052