Associations of blood pressure with functional and cognitive changes in patients with alzheimer's disease

Associations of blood pressure with functional and cognitive changes in patients with alzheimer's disease

Author de Oliveira, Fabricio Ferreira Autor UNIFESP Google Scholar
Chen, Elizabeth Suchi Autor UNIFESP Google Scholar
Smith, Marilia Cardoso Autor UNIFESP Google Scholar
Ferreira Bertolucci, Paulo Henrique Autor UNIFESP Google Scholar
Abstract Background: Midlife hypertension followed by late life hypotension resulting from neurodegeneration increases amyloidogenesis and tauopathy. Methods: Consecutive outpatients with late-onset Alzheimer's disease (AD) at various stages and their respective caregivers were assessed for score variations in 1 year of tests assessing caregiver burden, functionality and cognition according to blood pressure (BP) variations and APOE haplotypes, while also taking into account differential effects of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, diuretics, or no antihypertensive medication on score changes. The diagnosis and treatment of arterial hypertension followed the JNC 7 report. Results: Variations in systolic BP (-11.76 +/- 17.1 mm Hg), diastolic BP (-4.92 +/- 10.3 mm Hg) and pulse pressure (-6.84 +/- 12.6 mm Hg) were significant after 1 year (n = 191;. < 0.01). For APOE4+ carriers, rises in systolic or diastolic BP improved Clinical Dementia Rating Scale Sum of Boxes scores (rho < 0.04), with marginally significant improvements in MiniMental State Examination scores resulting from risen systolic (rho = 0.069) or diastolic BP (. = 0.079), and in basic independence only regarding risen diastolic BP (rho = 0.055). APOE4-carriers resisted any functional or cognitive effects of BP variations. No differences were found regarding any antihypertensive class for variations in BP or any test scores, regardless of APOE haplotypes. Conclusions: Targeting mild BP elevations brings better functional and cognitive results for APOE4+ carriers with AD. (C) 2016 S. Karger AG, Basel
Keywords Alzheimer's Disease
Cognitive Disorders
Dementia
Neurodegenerative Diseases
Hypertension
Activities Of Daily Living
Neuropsychiatry
ApoeVascular Risk-Factors
Dementia Rating-Scale
Sao-Paulo
Cardiovascular-Disease
Pulse Pressure
Follow-Up
Progression
Population
Decline
Variability
Language English
Sponsor Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) [1067/10]
State of Sao Paulo Research Foundation (FAPESP) [2015/10109-5]
Grant number CAPES: 1067/10
FAPESP: 2015/10109-5
Date 2016
Published in Dementia And Geriatric Cognitive Disorders. Basel, v. 41, n. 43256, p. 314-323, 2016.
ISSN 1420-8008 (Sherpa/Romeo, impact factor)
Publisher Consel Brasil Oftalmologia
Extent 314-323
Origin https://doi.org/10.1159/000447585
Access rights Closed access
Type Article
Web of Science ID WOS:000381877400008
URI http://repositorio.unifesp.br/handle/11600/49438

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