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Effect of the Interaction Between Hypertension and Cerebral White Matter Changes on the Progression of Alzheimer
Ping-Song Chou1,2, Yi-Hui Kao3, Meng-Ni Wu1
1Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Insights
Hypertension and white matter changes interact to accelerate Alzheimer's disease (AD) progression. This interaction, not independent effects, appears to drive AD advancement in hypertensive patients with cerebrovascular pathologies.
Area of Science:
- Neurology
- Gerontology
- Cardiovascular Research
Background:
- Alzheimer's disease (AD) progression is influenced by cerebrovascular pathologies and hypertension.
- The specific role of interaction versus independent effects of these conditions on AD progression remains unclear.
Purpose of the Study:
- To investigate the interactive effects of cerebrovascular pathologies and hypertension on Alzheimer's disease progression.
Main Methods:
- A retrospective longitudinal study analyzed 278 sporadic AD patients.
- Cerebral White Matter Changes (WMCs) were assessed using the Age-related WMCs (ARWMC) scale.
- Hypertension status and cognitive decline (CDR-SB, CDR) were evaluated annually.
Main Results:
- Hypertensive AD patients with cognitive decline showed more severe baseline ARWMC scores (total and frontal) compared to non-declining patients.
- No significant differences in ARWMC scores were found in non-hypertensive AD patients with or without cognitive decline.
- These findings suggest an interaction effect between hypertension and WMCs on AD progression.
Conclusions:
- Cerebrovascular pathologies may affect AD progression differently in hypertensive versus non-hypertensive individuals.
- An interaction between hypertension and white matter changes, rather than independent effects, likely influences Alzheimer's disease progression.
Background:
Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown.
Objective:
To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression.
Method:
A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC).
Results:
In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration.
Conclusion:
The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.
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