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Sydney, Australia — A recent meta-analysis reveals that untreated hypertension significantly elevates the risk of developing Alzheimer’s disease (AD) in older adults. According to the study led by Dr. Matthew J. Lennon, MD, PhD, from the School of Clinical Medicine at UNSW Sydney, individuals with untreated hypertension face a 36% higher risk of AD compared to those without hypertension and a 42% higher risk compared to those with treated hypertension.
Study Overview
The comprehensive analysis incorporated data from 31,250 participants aged 60 years or older (average age 72.1 years; 41% male) across 14 community-based studies spanning 14 countries. The mean follow-up period was 4.2 years, during which researchers recorded blood pressure measurements, hypertension diagnoses, and antihypertensive medication use.
Participants were categorized into three groups:
- 35.9% with no history of hypertension or antihypertensive medication use.
- 50.7% with a history of hypertension and antihypertensive medication use.
- 9.4% with a history of hypertension without antihypertensive medication use.
Findings
Out of the study cohort, 1,415 participants developed AD, while 681 developed non-AD dementia. The analysis found:
- Untreated Hypertension: Increased AD risk by 36% (hazard ratio [HR], 1.36; P = .041) compared to healthy controls and by 42% (HR, 1.42; P = .013) compared to those with treated hypertension.
- Treated Hypertension: No increased risk of AD compared to healthy controls (HR, 0.961; P = .6644).
- Both Treated and Untreated Hypertension: Associated with an elevated risk of non-AD dementia compared to healthy controls (treated HR, 1.285; P = .027; untreated HR, 1.693; P = .003), though the risk levels were similar between the two hypertension categories.
Clinical Implications
Dr. Lennon emphasized the importance of managing high blood pressure in aging populations to mitigate the risk of Alzheimer’s disease. “These results suggest that treating high blood pressure as a person ages continues to be a crucial factor in reducing their risk of Alzheimer’s disease,” he stated.
Limitations
The study acknowledges several limitations:
- Varied Definitions: Inconsistent definitions of hypertension across different locations might have influenced diagnosis.
- Unaccounted Confounders: Potential mediators such as stroke, transient ischemic attack, and heart disease were not considered.
- Mortality Data: Lack of mortality data might have impacted the interpretation of dementia risk.
Funding and Disclosures
The research was supported by the National Institute on Aging of the National Institutes of Health. Some authors disclosed affiliations with various institutions and pharmaceutical companies unrelated to this study. Detailed disclosures are available in the original publication.
This study, published online on August 14 in Neurology, underscores the critical need for effective hypertension management to prevent Alzheimer’s disease in the elderly.
