Blood Pressure, Antihypertensive Use, and Late-Life Alzheimer and Non-Alzheimer Dementia An Individual Participant Data Meta-Analysis

被引：0

作者：

Lennon, Matthew J. ^{[1
,2
]}

Lipnicki, Darren M. ^{[1
,2
]}

Lam, Ben Chun Pan ^{[1
,2
,3
]}

Crawford, John D. ^{[1
,2
]}

Schutte, Aletta E. ^{[4
,7
]}

Peters, Ruth ^{[4
,5
,6
]}

Rydberg-Sterner, Therese ^{[8
,9
,10
]}

Najar, Jenna ^{[8
,11
,12
]}

Skoog, Ingmar ^{[8
,11
]}

Riedel-Heller, Steffi G. ^{[13
]}

Rohr, Susanne ^{[13
,14
,15
]}

Pabst, Alexander ^{[13
]}

Lobo, Antonio ^{[16
,17
,18
]}

De-la-Camara, Concepcion ^{[16
,17
,18
]}

Lobo, Elena ^{[17
,18
,19
]}

Lipton, Richard B. ^{[20
,21
]}

Katz, Mindy J. ^{[20
]}

Derby, Carol A. ^{[20
,21
]}

Kim, Ki Woong ^{[22
,23
,24
]}

Han, Ji Won ^{[22
,23
]}

Oh, Dae Jong ^{[25
]}

Rolandi, Elena ^{[26
,27
]}

Davin, Annalisa ^{[26
]}

Rossi, Michele ^{[26
]}

Scarmeas, Nikolaos ^{[28
,29
]}

Yannakoulia, Mary ^{[30
]}

Dardiotis, Themis ^{[31
,32
]}

Hendrie, Hugh C. ^{[33
,34
]}

Gao, Sujuan ^{[34
,35
]}

Carriere, Isabelle ^{[36
]}

Ritchie, Karen ^{[36
,37
]}

Anstey, Kaarin J. ^{[38
,39
]}

Cherbuin, Nicolas ^{[40
]}

Xiao, Shifu ^{[41
,42
]}

Yue, Ling ^{[41
,42
]}

Li, Wei ^{[41
,42
]}

Guerchet, Maelenn ^{[43
,44
]}

Preux, Pierre-Marie ^{[43
]}

Aboyans, Victor ^{[43
,45
]}

Haan, Mary N. ^{[46
]}

Aiello, Allison ^{[47
]}

Scazufca, Marcia ^{[48
]}

Sachdev, Perminder S. ^{[1
,2
,49
]}

机构：

[1] Univ New South Wales, Fac Med & Hlth, Sch Clin Med, Discipline Psychiat & Mental Hlth, Sydney, Australia

[2] Univ New South Wales, Ctr Hlth Brain Aging CHeBA, Sch Clin Med, Discipline Psychiat & Mental Hlth, Sydney, Australia

[3] La Trobe Univ, Sch Psychol & Publ Hlth, Melbourne, Australia

[4] George Inst Global Hlth, Barangaroo, Australia

[5] Univ New South Wales, Sch Biomed Sci, Sydney, Australia

[6] Imperial Coll London, Sch Publ Hlth, London, England

[7] Univ New South Wales, Sch Populat Hlth, Sydney, Australia

[8] Univ Gothenburg, Inst Neurosci & Physiol, Sahlgrenska Acad, Ctr Ageing & Hlth AGECAP,Neuropsychiat Epidemiol U, Gothenburg, Sweden

[9] Karolinska Inst, Aging Res Ctr, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden

[10] Stockholm Univ, Stockholm, Sweden

[11] Sahlgrens Univ Hosp, Psychiat Cognit & Old Age Psychiat Clin, Reg Vastra Gotaland, Gothenburg, Sweden

[12] Vrije Univ Amsterdam, Dept Clin Genet, Sect Genom Neurodegenerat Dis & Aging, Amsterdam UMC, Amsterdam, Netherlands

[13] Univ Leipzig, Inst Social Med, Med Fac, Occupat Hlth & Publ Hlth ISAP, Leipzig, Germany

[14] Massey Univ, Sch Psychol, Albany Campus, Auckland, New Zealand

[15] Trinity Coll Dublin, Global Brain Hlth Inst GBHI, Dublin, Ireland

[16] Univ Zaragoza, Dept Med & Psychiat, Zaragoza, Spain

[17] Inst Invest Sanit Aragon IIS Aragon, Zaragoza, Spain

[18] CIBERSAM, Madrid, Spain

[19] Univ Zaragoza, Dept Prevent Med & Publ Hlth, Zaragoza, Spain

[20] Albert Einstein Coll Med, Dept Neurol, Bronx, NY USA

[21] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY USA

[22] Seoul Natl Univ, Dept Neuropsychiat, Bundang Hosp, Seongnam, South Korea

[23] Seoul Natl Univ, Coll Med, Dept Psychiat, Seoul, South Korea

[24] Seoul Natl Univ, Coll Nat Sci, Dept Brain & Cognit Sci, Seoul, South Korea

[25] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Workplace Mental Hlth Inst, Sch Med, Seoul, South Korea

[26] Golgi Cenci Fdn, Abbiategrasso, Milan, Italy

[27] Univ Pavia, Dept Brain & Behav Sci, Pavia, Italy

[28] Natl & Kapodistrian Univ Athens, Aiginit Hosp, Dept Neurol 1, Athens, Greece

[29] Columbia Univ, Dept Neurol, New York, NY USA

[30] Harokopio Univ, Sch Hlth Sci & Educ, Dept Nutr & Dietet, Kallithea, Greece

[31] Univ Hosp Larissa, Dept Neurol, Larisa, Greece

[32] Univ Thessaly, Fac Med, Sch Hlth Sci, Larisa, Greece

[33] Indiana Univ Sch Med, Dept Psychiat, Indianapolis, IN USA

[34] Indiana Alzheimer Dis Res Ctr, Indianapolis, IN USA

[35] Indiana Univ Sch Med, Dept Biostat & Hlth Data Sci, Indianapolis, IN USA

[36] Univ Montpellier, Inst Neurosci Montpellier INM, INSERM, Montpellier, France

[37] Inst Cerveau Trocadero, Paris, France

[38] Univ New South Wales, Sch Psychol, Sydney, Australia

[39] Univ New South Wales, Ageing Futures Inst, Sydney, Australia

[40] Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, Australia

[41] Shanghai Jiao Tong Univ, Shanghai Mental Hlth Ctr, Sch Med, Dept Geriatr Psychiat, Shanghai, Peoples R China

[42] Shanghai Jiao Tong Univ, Alzheimers Dis & Related Disorders Ctr, Shanghai, Peoples R China

[43] Univ Limoges, Inst Epidemiol & Trop Neurol, OmegaHlth, Inserm U1094,IRD UMR270,CHU Limoges,EpiMaCT Epidem, Limoges, France

[44] Univ Abomey Calavi, Fac Hlth Sci, Lab Chron & Neurol Dis Epidemiol LEMACEN, Cotonou, Benin

[45] Dupuytren 2 Univ Hosp, Dept Cardiol, Limoges, France

[46] Univ Calif San Francisco, Sch Med, San Francisco, CA USA

[47] Columbia Univ, Robert N Butler Columbia Aging Ctr, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY USA

[48] Univ Sao Paulo, Fac Med FMUSP, Dept Psiquiatria, Sao Paulo, Brazil

[49] Prince Wales Hosp, Neuropsychiat Inst, Sydney, Australia

来源：

NEUROLOGY | 2024年 / 103卷 / 05期

基金：

英国惠康基金; 巴西圣保罗研究基金会; 瑞典研究理事会; 英国医学研究理事会; 澳大利亚国家健康与医学研究理事会;

关键词：

RISK-FACTORS; COGNITIVE IMPAIRMENT; DOUBLE-BLIND; TASK-FORCE; DISEASE; PREVALENCE; STROKE; HYPERTENSION; ASSOCIATION; PREVENTION;

D O I：

暂无

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Objectives 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 Alzheimer dementia (AD) and non-AD risk remains unclear. This study investigates whether previous hypertension or antihypertensive use modifies AD or non-AD risk in late life and the ideal blood pressure (BP) for risk reduction in a diverse consortium of cohort studies. Methods This individual participant data meta-analysis included community-based longitudinal studies of aging from a preexisting consortium. The main outcomes were risk of developing AD and non-AD. The main exposures were hypertension history/antihypertensive use and baseline systolic BP/diastolic BP. Mixed-effects Cox proportional hazards models were used to assess risk and natural splines were applied to model the relationship between BP and the dementia outcomes. The main model controlled for age, age2, sex, education, ethnoracial group, and study cohort. Supplementary analyses included a fully adjusted model, an analysis restricting to those with >5 years of follow-up and models that examined the moderating effect of age, sex, and ethnoracial group. Results There were 31,250 participants from 14 nations in the analysis (41% male) with a mean baseline age of 72 (SD 7.5, range 60-110) years. Participants with untreated hypertension had a 36% (hazard ratio [HR] 1.36, 95% CI 1.01-1.83, p = 0.0406) and 42% (HR 1.42, 95% CI 1.08-1.87, p = 0.0135) increased risk of AD compared with "healthy controls" and those with treated hypertension, respectively. Compared with "healthy controls" both those with treated (HR 1.29, 95% CI 1.03-1.60, p = 0.0267) and untreated hypertension (HR 1.69, 95% CI 1.19-2.40, p = 0.0032) had greater non-AD risk, but there was no difference between the treated and untreated groups. Baseline diastolic BP had a significant U-shaped relationship (p = 0.0227) with non-AD risk in an analysis restricted to those with 5-year follow-up, but otherwise there was no significant relationship between baseline BP and either AD or non-AD risk. Discussion Antihypertensive use was associated with decreased AD but not non-AD risk throughout late life. This suggests that treating hypertension throughout late life continues to be crucial in AD risk mitigation. A single measure of BP was not associated with AD risk, but DBP may have a U-shaped relationship with non-AD risk over longer periods in late life.

引用

页数：18

共 51 条

[1] Antihypertensive Agents and Incident Alzheimer's Disease: A Systematic Review and Meta-Analysis of Observational Studies [J].