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Updated: Jan 7, 2026

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

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Hypertension is the Main Vascular Risk Factor for Cognitive Impairment, Microvascular Pathology and Brain Atrophy in

Shailendra Mohan Tripathi1,2, Helen Shiells3, Jennifer Waymont4

  • 1Department of Geriatric Mental Health, King George's Medical University, UP, Lucknow, 226003, India.

Current Alzheimer Research
|January 5, 2026
PubMed

Insights

Vascular risk factors, particularly hypertension, are more common in typical Alzheimer's Disease (AD) than mixed AD. Microvascular pathology, not brain atrophy, significantly impacts cognitive function in hypertensive AD patients.

Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Alzheimer's Disease (AD) frequently coexists with cerebrovascular disease (CVD).
  • Vascular risk factors (VRFs) like hypertension, diabetes, and dyslipidemia may influence AD pathogenesis.
  • Understanding VRF impact on AD subtypes is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the association between VRFs and distinct AD subtypes (typical AD vs. mixed AD).
  • To determine if VRFs contribute to typical AD or comorbid CVD in mixed AD.
  • To explore the role of microvascular pathology in hypertensive AD patients.

Main Methods:

  • Classified 794 probable AD subjects into typical AD and mixed subtypes using FDG-PET imaging.
  • Analyzed VRFs (hypertension, diabetes, dyslipidemia) and MRI-derived measures (WMHs, brain atrophy).
  • Investigated relationships between VRFs and AD subtypes.

Main Results:

  • 67.1% of participants had typical AD, 32.8% had mixed AD.
  • Cardiovascular risks were significantly more frequent in typical AD (59%) than mixed AD (47%).
  • Hypertension prevalence differed significantly between AD subtypes.

Conclusions:

  • Hypertension is more prevalent in typical AD than mixed AD, contrary to expectations.
  • Microvascular pathology (WMHs) is significantly higher in hypertensive patients, irrespective of AD subtype.
  • Microvascular pathology contributes to cognitive impairment in typical AD, driven by hypertension.
Abstract

Keywords:
Alzheimer’s diseaseFDG-PETbrain atrophydiabetesdyslipidemiahypertension

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