Related Experiment Video
Updated: May 10, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Relationships between blood pressure indicators and fluid biomarkers of brain aging in functionally intact older
Anna M VandeBunte1,2, Bailey L Ortiz1,2, Emily W Paolillo1
1Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.
Insights
Elevated pulse pressure, a measure of blood pressure, is linked to higher levels of dementia-related biomarkers in older adults. Managing blood pressure, especially pulse pressure, may help reduce dementia risk and support brain health.
Area of Science:
- Neuroscience
- Cardiovascular Health
- Biomarker Research
Background:
- Cardiovascular health significantly influences dementia risk, with hypertension being a major factor in brain aging.
- Blood biomarkers like pTau181, Aβ42/40, NfL, and GFAP aid in understanding dementia, but their link to specific blood pressure metrics needs further exploration for personalized prevention.
- This study investigates the association between various blood pressure metrics and key plasma biomarkers related to neurodegeneration and Alzheimer's disease pathology.
Purpose of the Study:
- To examine the relationship between different blood pressure metrics (diastolic, systolic, pulse pressure) and plasma biomarkers (pTau181, Aβ42/40, NfL, GFAP).
- To explore how these associations may differ based on sex, age, or APOE-ε4 status.
- To inform personalized dementia prevention strategies by linking cardiovascular health indicators to molecular markers of brain aging.
Main Methods:
- 109 cognitively intact older adults underwent blood draws for plasma biomarker analysis (pTau181, Aβ42/40, NfL, GFAP).
- In-lab blood pressure measurements included diastolic, systolic, and pulse pressure.
- Regression models assessed biomarker levels as a function of blood pressure metrics, adjusting for age and sex, with interaction models exploring differential effects.
Main Results:
- Higher pulse pressure correlated with increased levels of pTau181, NfL, and GFAP, but not Aβ42/40.
- Elevated systolic blood pressure was associated with higher pTau181, while diastolic blood pressure showed no significant association.
- Significantly stronger associations were observed between higher pulse pressure and elevated GFAP in females and lower Aβ42/40 in APOE-ε4 carriers.
Conclusions:
- Elevated pulse pressure and, to a lesser extent, systolic blood pressure are linked to increased markers of Alzheimer's disease and neurodegeneration in aging adults.
- These findings highlight the importance of managing blood pressure, particularly pulse pressure, for dementia risk reduction.
- Integrating cardiovascular health data with biomarker information can enhance personalized dementia prevention and management approaches.
Background:
Dementia risk is significantly shaped by cardiovascular health, with elevated blood pressure emerging as a key risk factor for adverse brain aging. Blood biomarkers such as pTau181, Aβ42/40, NfL, and GFAP have improved our understanding of dementia pathophysiology, however, few studies have explored how specific blood pressure metrics relate to biomarker levels, which could inform personalized dementia prevention strategies as these biomarkers move into clinic. We examined how different blood pressure metrics associated with molecular markers of astrocytic activation (GFAP), neuronal axon breakdown (NfL), and Alzheimer's disease pathobiology (pTau181, Aβ42/40) in plasma.
Methods:
109 functionally intact (Clinical Dementia Rating Scale = 0) older adults completed blood draws with plasma assayed for Aβ42/40, GFAP, NfL, and pTau181 (Quanterix Simoa) and in-lab blood pressure quantification. Blood pressure metrics included diastolic blood pressure, systolic blood pressure, and pulse pressure (systolic minus diastolic). Separate regression models evaluated plasma biomarkers as a function of each blood pressure metric, adjusting for age and biological sex. Interaction models tested whether relationships between blood pressure metrics and plasma biomarkers differed by sex, age, or APOE-ε4 status.
Results:
With the exception of Aβ42/40, higher pulse pressure related to higher levels of all plasma biomarkers examined (pTau181, NfL, GFAP). Additionally, higher systolic blood pressure related to higher pTau181, while diastolic blood pressure did not meaningfully associate with any biomarker. Interaction models revealed a significantly stronger relationship between elevated pulse pressure and higher GFAP concentrations in females compared to males, as well as a significantly stronger association between elevated pulse pressure and lower Aβ42/40 plasma concentrations in APOE-ε4 carriers compared to non-carriers.
Conclusions:
Our findings suggest that elevated pulse pressure, and to a lesser extent systolic blood pressure, are associated with increased Alzheimer's disease and neurodegenerative (axonal and astrocytic health) biology among typically aging adults. These associations underscore the importance of blood pressure management, particularly pulse pressure, for reducing dementia risk. Cardiovascular health may be incorporated with biomarkers to further personalize dementia prevention and management strategies.
Related Concept Videos
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:18Hypertension and Regulation of Blood Pressure
01:17Measurement of Blood Pressure
01:28Factors affecting Blood pressure
Physiological Factors: