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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Blood pressure decrease correlates with tau pathology and memory decline in hypertensive elderly.

Lidia Glodzik¹, Henry Rusinek, Elizabeth Pirraglia

¹Department of Psychiatry, Center for Brain Health, New York University School of Medicine, New York, NY, USA; Department of Radiology, New York University School of Medicine, New York, NY, USA.

Neurobiology of Aging

|August 24, 2013

Summary

This summary is machine-generated.

Hypertension (HTN) may make individuals sensitive to blood pressure (BP) reductions, potentially impacting memory and Alzheimer's biomarkers. Lowering BP in those with HTN requires careful consideration due to increased brain vulnerability.

Keywords:

CSF biomarkers Cognition Low blood pressure

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Area of Science:

Neurology
Gerontology
Cardiovascular Science

Background:

Hypertension (HTN) alters cerebral blood flow regulation, potentially increasing brain vulnerability to reduced blood pressure (BP).
Cognitively healthy elderly individuals with HTN may have a higher threshold for safe BP maintenance.
The impact of longitudinal BP changes on Alzheimer's disease (AD) biomarkers in this population is not fully understood.

Purpose of the Study:

To investigate the relationship between changes in mean arterial pressure (MAP) and cerebrospinal fluid (CSF) biomarkers of AD.
To examine the association of MAP changes with memory decline and hippocampal atrophy.
To determine if these relationships differ between individuals with and without HTN.

Main Methods:

Longitudinal study of 77 cognitively healthy elderly subjects (25 with HTN) assessed twice over approximately 2 years.
Evaluations included medical history, neuropsychological testing, lumbar puncture for CSF biomarkers, and magnetic resonance imaging (MRI).
Analysis focused on changes in MAP, CSF phosphorylated tau (p-tau(181)), verbal episodic memory, and hippocampal volume (HipV).

Main Results:

No baseline differences in CSF biomarkers, HipV, or memory scores between hyper- and normotensive groups.
Increased p-tau(181) correlated with memory decline and HipV reduction in the overall group.
A longitudinal decrease in MAP was significantly associated with memory decline and increased p-tau(181) specifically in the hypertensive group.

Conclusions:

The hypertensive group demonstrated sensitivity to BP reductions, linking decreased MAP to cognitive decline and AD biomarker changes.
Findings suggest that hypertensive individuals may be more vulnerable to the effects of lowered BP on brain health.
Further research is needed to understand the clinical implications of BP management in hypertensive elderly individuals concerning cognitive function and AD pathology.