Risk for Alzheimer’s disease and non-Alzheimer dementia was affected by hypertension and antihypertensive use in a large international dataset of older adults.

Hypertension is a risk factor for all-cause dementia. Using individual patient data from an international cohort of 31,250 participants of studies from 14 European, African, Asian, North American and South American countries and Australia (41% male; mean age, 72 years; mean baseline blood pressure 138/80mmHg), researchers in this study determined whether antihypertensive use was associated with incident dementia in three participant categories: a control group without a hypertension history or antihypertensive use at baseline, a treated hypertension group with a history of hypertension and antihypertensive use who were normotensive at baseline, and an untreated hypertension group with hypertension at baseline and no antihypertensive use. Alzheimer’s disease (AD) dementia and non-AD dementia diagnoses were based on standardised criteria.

After a mean follow up of four years, participants in the untreated hypertension group had a 36% increased risk for AD dementia compared with controls and a 42% increased risk for AD dementia compared with participants with treated hypertension. Compared with controls, the untreated hypertension and treated hypertension groups had an increased risk for non-AD dementia, although the two hypertension groups did not differ in non-AD dementia risk. Race did not affect these results. Baseline blood pressure measurements did not affect AD risk, but baseline diastolic blood pressure had a U-shaped effect on non-AD dementia risk in those with a follow up of more than five years.

Comment: These results support treating hypertension to decrease risk for late-life dementia, especially AD risk. A strength of this study is the inclusion of multiple races and ethnicities. However, determining a target blood pressure for treatment is still needed.

Jennifer Rose V. Molano, MD, Associate Professor, Department of Neurology and Rehabilitation Medicine, The University of Cincinnati, Ohio, USA.

Lennon MJ, et al. Blood pressure, antihypertensive use, and late-life Alzheimer and non-Alzheimer dementia risk: an individual participant data meta-analysis. Neurology 2024; 103: e209715.

The summary is taken from the following Journal Watch title: Neurology