Pulse pressure and risk of Alzheimers disease in persons aged 75 years and older : a community-based, longitudinal study
Chengxuan Qiu, Bengt Winblad, Matti Viitanen, Laura Fratiglioni
Bok Svensk 2003
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| Utgitt | 2003
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| Omfang | 6 s.
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| Opplysninger | Background and Purpose: Elevated blood pressure has been found to increase the risk of dementia, including Alzheimer disease. We sought to investigate wether pulse pressure was predictive of Alzheimer disease and dementia. Methods - A community-based, dementia-free cohort (n=1270) aged>_ 75 years was clinically examined twice over 6 years to detect incident dementia with the use of criteria of the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Cox proportional hazards models were used to analyze pulse pressure in association with incident Alzheimer disease and dementia after adjustment for serveral potential confounders, including systolic pressure and diastolic pressure. Results - During the 5464.6 person-years (median, 4.7 years) of follow-up, 339 subjects developed dementia, including 256 Alzheimer disease cases. Pulse pressure as a continuous variable was not statistically related to the risk of Alzheimer disease and dementia. In the categorical analysis, however , in comparison with median tertile of pulse pressure (70 to 84 mm Hg), subjects with higher pulse pressure had adjusted relative risks (95%CI) of 1.4 (1.0 to 2.0; P=0.04) for Alzheimer disease and 1.3 (0.9 to 1.7) for dementia. The corresponding figures related to lower pulse pressure were 1.7 (1.2 to 2.3) for Alzheimer disease and 1.4 (1.0 to 1.9; P=0.03) for dementia. This association was particularly pronounced among women. Conclusions - Higher pulse pressure is associated with increased risk of Alzheimer disease and dementia in old adults, wich is probably due to artery stiffness and serve atherosclerosis. Poor cerebral perfusione related to decreased pulse pressure max explain the association between lower pulse pressure and increased dementia risk
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