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

NEUROBIOLOGY OF AGING

卷:35

Article

Glodzik, Lidia^1,2  Rusinek, Henry²  Pirraglia, Elizabeth¹  McHugh, Pauline¹  Tsui, Wai¹  Williams, Schantel¹  Cummings, Megan¹  Rich, Kenneth¹  Randall, Catherine¹  Mosconi, Lisa¹  Osorio, Ricardo¹  Murray, John¹  Zetterberg, Henrik^3,4  Blennow, Kaj³  de Leon, Mony¹ 

[1] NYU, Sch Med, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA

[2] NYU, Sch Med, Dept Radiol, New York, NY 10016 USA

[3] Univ Gothenburg, Dept Psychiat & Neurochem, Inst Neurosci & Physiol, Sahlgrenska Acad, Molndal, Sweden

[4] UCL, Inst Neurol, London, England

关键词: Low blood pressure;    CSF biomarkers;    Cognition;   

DOI  :  10.1016/j.neurobiolaging.2013.06.011

来源: Elsevier

【 摘 要 】

In hypertension (HTN), cerebral blood flow regulation limits are changed, and the threshold for blood pressure (BP) at which perfusion is safely maintained is higher. This shift may increase the brain's vulnerability to lower BP in subjects with vascular disease. We investigated whether longitudinal reduction in mean arterial pressure (MAP) was related to changes in cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease in a group of cognitively healthy elderly with and without HTN. The relationships among MAP, memory decline, and hippocampal atrophy were also examined. Seventy-seven subjects (age 63.4 +/- 9.4, range 44-86 years; education 16.9 +/- 2.1, range 10-22 years; 60% women) were assessed twice, 2 +/- 0.5 years apart. At both time points, all subjects underwent full medical and neuropsychological evaluations, lumbar punctures, and magnetic resonance imaging examinations. Twenty-five subjects had HTN. Hyper-and normotensive subjects did not differ in their CSF biomarkers, hippocampal volumes (HipVs), or memory scores at baseline. In the entire study group, the increase in tau phosphorylated at threonine 181 (p-tau(181)) was associated with a decline in verbal episodic memory (beta = -0.30, p = 0.01) and HipV reduction (beta = -0.27, p = 0.02). However, longitudinal decrease in MAP was related to memory decline (beta = 0.50, p = 0.01) and an increase in p-tau181 (beta = -0.50, p = 0.01) only in subjects with HTN. Our findings suggest that the hypertensive group may be sensitive to BP reductions. (C) 2014 Elsevier Inc. All rights reserved.

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