journal articles
ANTI-HYPERTENSIVE DRUGS MODERATE THE RELATIONSHIP OF BLOOD PRESSURE WITH ALZHEIMER’S PATHOLOGIES AND NEURODEGENERATIVE MARKERS IN NON-DEMENTED HYPERTENSIVE OLDER ADULTS
Y. Guo, C.-C. Tan, M.-S. Tan, L. Tan, W. Xu, for the Alzheimer’s Disease Neuroimaging Initiative
J Prev Alz Dis 2024;3(11):672-683
BACKGROUND: We aimed to explore whether the relationships of blood pressures (BPs) with Alzheimer’s disease (AD) endophenotypes varied by usage of antihypertensive drugs (AHDs).
METHODS: A total of 765 non-demented older adults (mean age: 74.4 years; female: 43.1%) with a self-reported history of hypertension were followed for 6 years. Multiple linear regression and linear-mixed effect models were used to investigate the interaction effects of five categories of AHDs (angiotensin-converting enzyme inhibitors [ACEI], angiotensin II receptor blockers [ARBs], β-blocker, calcium channel blockers [CCB], diuretic) with BPs (systolic blood pressure [SBP], diastolic blood pressure [DBP], and pulse pressure [PP]) on AD core pathology and neurodegenerative markers.
RESULTS: After Bonferroni correction, significant interaction effects of BPs with AHDs were observed. Elevated SBP or PP in late-life was associated with higher levels of cerebral Aβ burden (diuretic alone/β-blocker × SBP), higher levels of CSF tau proteins (diuretic × SBP/PP, ARBs/CCB × SBP), and lower volume of entorhinal region (β-blocker × SBP, diuretic × PP) only among hypertensive patients who received no anti-hypertensive treatments, while these associations became compromised or null for users of specific AHDs except for ACEI. Compared to taking other classes of AHDs, elevated SBP in late-life was associated with lower cerebral Aβ burden in diuretic users (padjusted = 0.08) and was associated with higher CSF tau proteins in ACEI alone users (padjusted = 0.03). Longitudinal data validated the above-mentioned interaction effects on changes of cerebral Aβ burden (padjusted < 0.05), CSF tau proteins (padjusted < 0.10), and brain atrophy (padjusted < 0.05).
CONCLUSIONS: The relationships of late-life BP with AD pathology and neurodegeneration could be modified by anti-hypertensive treatments and varied by AHD classification. These findings provide preliminary evidence for tailored BP management strategy for preventing AD among late-life hypertensive adults.
CITATION:
Y. Guo ; C.-C. Tan ; M.-S. Tan ; L. Tan ; W. Xu ; for the Alzheimer’s Disease Neuroimaging Initiative (2024): Anti-Hypertensive Drugs Moderate the Relationship of Blood Pressure with Alzheimer’s Pathologies and Neurodegenerative Markers in Non-Demented Hypertensive Older Adults. The Journal of Prevention of Alzheimer’s Disease (JPAD). http://dx.doi.org/10.14283/jpad.2024.40