Association Between Short-Term Blood Pressure Variability and the Alzheimer's Disease Continuum.

Area of Science:

• Neurology
• Cardiology
• Gerontology

Background:

• Emerging evidence suggests blood pressure variability (BPV) is a modifiable vascular risk factor for Alzheimer's disease (AD).
• Short-term BPV's role across the AD continuum requires systematic evaluation.

Purpose of the Study:

• To systematically evaluate the potential role of short-term blood pressure variability (BPV) in individuals across the Alzheimer's disease (AD) continuum.
• To investigate the associations between BPV and neuropsychological, fluid, and neuroimaging markers of AD.

Main Methods:

• Included 263 patients on the AD continuum.
• Utilized 24-h ambulatory blood pressure monitoring to assess BPV.
• Employed correlation, restricted cubic spline, and mediation analyses to examine relationships between BPV, clinical outcomes, and neuroimaging measures.

Main Results:

• Elevated nightly diastolic and systolic blood pressure variability correlated with increased neuropsychiatric symptoms and anxiety.
• Nightly systolic blood pressure variability was associated with altered Aβ42/40 levels and cognitive function.
• Specific brain regions, including the left cuneus and right medial orbitofrontal cortex, mediated the relationship between BPV and clinical outcomes.

Conclusions:

• Short-term blood pressure variability is implicated in the Alzheimer's disease continuum.
• Findings support a vascular pathway contributing to AD pathogenesis.
• BPV represents a potential, accessible intervention target for managing AD progression.