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Hypertension is associated with worse cognitive function and hippocampal hypometabolism in Alzheimer's disease

Research output: Contribution to journalArticlepeer-review

I. Moonga, F. Niccolini, H. Wilson, G. Pagano, M. Politis

Original languageEnglish
Pages (from-to)1173–1182
JournalEuropean Journal of Neurology
Volume24
Issue number9
Early online date28 Jul 2017
DOIs
Accepted/In press12 Jun 2017
E-pub ahead of print28 Jul 2017
PublishedSep 2017

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Abstract

Background and purpose: A growing body of evidence suggests that cardiovascular disease risk factors including hypertension may be linked to sporadic Alzheimer's disease (AD). It is well known that hypertension is associated with cerebrovascular disease and vascular dementia on the basis of vascular remodeling. However, the mechanisms linking hypertension and AD remain unclear. Methods: We studied 197 patients with AD (86 male; mean age ± SD: 75.8 ± 7.4 years) from the Alzheimer's Disease Neuroimaging Initiative database with (n = 97) and without (n = 100) hypertension. We explored associations between hypertension and clinical, plasma, cerebrospinal fluid and imaging markers of AD pathology in order to elucidate the underlying mechanisms that may link AD and hypertension. Results: We found that patients with AD with hypertension had worse cognitive function (Alzheimer's disease Assessment Scale-cognitive subscale, P = 0.038) and higher neuropsychiatric symptom burden (Neuropsychiatric Inventory Questionnaire, P = 0.016) compared with those without hypertension. Patients with AD with hypertension showed reduced glucose hypometabolism in the right (P < 0.001) and left (P = 0.007) hippocampus. No differences were found in magnetic resonance imaging volumetric measurements, [18F]florbetapir uptakes, plasma and cerebrospinal fluid between patients with AD with and without hypertension. Conclusions: Although hypertension is associated with worse cognitive function, behavioural symptoms and hippocampal glucose hypometabolism, it is not associated with evidence of increased amyloid or tau pathology. Effective management of hypertension may potentially have a therapeutic role in the alleviation of symptoms in AD.

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