4.7 Article

Visit-to-Visit Blood Pressure Variability and Longitudinal Tau Accumulation in Older Adults

期刊

HYPERTENSION
卷 79, 期 3, 页码 629-637

出版社

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.121.18479

关键词

aging; Alzheimer disease; blood pressure; dementia; tau protein

资金

  1. National Institutes of Health/National Institute on Aging (NIH/NIA) [R01AG064228, R01AG060049, P50AG016573, P01AG052350]
  2. Alzheimer's Association [AARG-17532905]
  3. ADNI (Alzheimer's Disease Neuroimaging Initiative)
  4. National Institutes of Health [U01 AG024904]
  5. DOD ADNI (Department of Defense) [W81XWH-12-2-0012]
  6. National Institute on Aging
  7. National Institute of Biomedical Imaging and Bioengineering
  8. Alzheimer's Drug Discovery Foundation
  9. Araclon Biotech
  10. Biogen
  11. Bristol-Myers Squibb Company
  12. CereSpir, Inc
  13. Cogstate
  14. Eisai Inc
  15. Elan Pharmaceuticals, Inc
  16. Eli Lilly and Company
  17. EuroImmun
  18. F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc
  19. Fujirebio
  20. GE Healthcare
  21. IXICO Ltd
  22. Janssen Alzheimer Immunotherapy Research & Development, LLC
  23. Lumosity
  24. Lundbeck
  25. Merck Co, Inc
  26. Meso Scale Diagnostics, LLC
  27. NeuroRx Research
  28. Neurotrack Technologies
  29. Novartis Pharmaceuticals Corporation
  30. Pfizer, Inc
  31. Piramal Imaging
  32. Servier
  33. Takeda Pharmaceutical Company
  34. Transition Therapeutics
  35. Canadian Institutes of Health Research
  36. BioClinica, Inc

向作者/读者索取更多资源

This study found that blood pressure variability (BPV) in older adults is related to tau accumulation in brain regions vulnerable to Alzheimer's disease, independent of average blood pressure levels. The relationship is modified by APOE ε4 carrier status. BPV may serve as a marker of vascular dysfunction contributing to early-stage tau pathology in Alzheimer's disease.
Background: Elevated blood pressure variability (BPV) is predictive of dementia, independent of average blood pressure levels, but neuropathological mechanisms remain unclear. We examined whether BPV in older adults is related to tau accumulation in brain regions vulnerable to Alzheimer disease and whether relationships are modified by apo epsilon 4 carrier status. Methods: Two hundred eighty-six Alzheimer's Disease Neuroimaging Initiative participants without history of dementia underwent 3 to 4 blood pressure measurements over 12 months and >= 1 tau positron emission tomography thereafter. BPV was calculated as variability independent of mean. Each scan determined tau burden (standardized uptake value ratio) for a temporal meta-region of interest, including burden from entorhinal cortex, amygdala, parahippocampus, fusiform, inferior temporal, and middle temporal. Bayesian linear growth modeling examined the role of BPV, apolipoprotein epsilon 4 carrier status, and time on regional tau accumulation after controlling for several variables, including baseline hypertension. Results: Elevated BPV was related to tau accumulation at follow-up in a temporal meta-region, independent of average blood pressure levels (ss, 0.89 [95% credible interval, 0.86-0.92]) and especially in entorhinal cortex (ss, 2.57 [95% credible interval, 2.15-2.99]). Apo epsilon 4 carriers with elevated BPV had the fastest tau accumulation at follow-up (ss, 1.73 [95% credible interval, 0.47-3.03]). Conclusions: BPV is related to tau accumulation in brain regions vulnerable to Alzheimer disease, independent of average blood pressure. APOE epsilon 4 modified this relationship. Bidirectionality of findings is possible. BPV may represent a marker of vascular dysfunction related to early-stage tau pathology contributing to Alzheimer disease.

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