Ambulatory Blood Pressure Characteristics of Patients with Alzheimer’s Disease: A Multicenter Study from China

2021 ◽  
Vol 83 (3) ◽  
pp. 1333-1339
Author(s):  
Hualong Wang ◽  
Ying Xu ◽  
Rujing Ren ◽  
Feng Yao ◽  
Mei Chen ◽  
...  

Background: Previous studies revealed that abnormal blood pressure (BP) plays an important role in the pathogenesis of Alzheimer’s disease (AD). However, little is known about the ambulatory BP characteristics of AD in the mild or severe stage. Objective: We explored the ambulatory BP characteristics of AD in the mild or severe stage. Methods: In the present study, 106 AD patients (42.5%male, average age 81.6 years) were enrolled from three centers in China. Clinal BP measurements at the supine and standing positions, neurological evaluations, and the 24 h ambulatory BP monitoring were performed. Results: In the 106 AD patients, 49.2%, 36.8%, and 70%of patients had 24 h, daytime, and nighttime systolic hypertension, respectively, while 19.8%, 29.2%, and 5.7%had 24 h, daytime, and nighttime diastolic hypotension. The prevalence of the reduced and reverse dipping pattern was 34.0%and 48.1%for systolic BP and 32.1%and 45.3%for diastolic BP, respectively. The daytime diastolic BP was significantly correlated with cognitive performance. After adjustment for age, sex, and body mass index, only daytime diastolic BP was associated with remarkable cognitive deterioration (p≤0.008). Further, AD patients in the severe stage had significantly lower levels of the 24 h, daytime, and nighttime diastolic BP, compared with those in the mild stage. Conclusion: In general, AD patients were featured with high nighttime systolic BP, low daytime diastolic BP, and abnormal circadian BP rhythm of reduced and reverse dipping. The diastolic BP, especially daytime diastolic BP, was adversely correlated with the cognitive deterioration in AD.

2020 ◽  
Vol 17 (2) ◽  
pp. 185-195
Author(s):  
Jianxiong Xi ◽  
Ding Ding ◽  
Qianhua Zhao ◽  
Xiaoniu Liang ◽  
Li Zheng ◽  
...  

Background: Approximately 40 independent Single Nucleotide Polymorphisms (SNPs) have been associated with Alzheimer’s Disease (AD) or cognitive decline in genome-wide association studies. Methods: We aimed to evaluate the joint effect of genetic polymorphisms and environmental factors on the progression from Mild Cognitive Impairment (MCI) to AD (MCI-AD progression) in a Chinese community cohort. Conclusion: Demographic, DNA and incident AD diagnosis data were derived from the follow-up of 316 participants with MCI at baseline of the Shanghai Aging Study. The associations of 40 SNPs and environmental predictors with MCI-AD progression were assessed using the Kaplan-Meier method with the log-rank test and Cox regression model. Results: Rs4147929 at ATP-binding cassette family A member 7 (ABCA7) (AG/AA vs. GG, hazard ratio [HR] = 2.43, 95% confidence interval [CI] 1.24-4.76) and body mass index (BMI) (overweight vs. non-overweight, HR = 0.41, 95% CI 0.22-0.78) were independent predictors of MCI-AD progression. In the combined analyses, MCI participants with the copresence of non-overweight BMI and the ABCA7 rs4147929 (AG/AA) risk genotype had an approximately 6-fold higher risk of MCI-AD progression than those with an overweight BMI and a non-risk genotype (HR = 6.77, 95% CI 2.60-17.63). However, a nonsignificant result was found when participants carried only one of these two risk factors (nonoverweight BMI and AG/AA of ABCA7 rs4147929). Conclusion: ABCA7 rs4147929 and BMI jointly affect MCI-AD progression. MCI participants with the rs4147929 risk genotype may benefit from maintaining an overweight BMI level with regard to their risk for incident AD.


2009 ◽  
Vol 28 (5) ◽  
pp. 427-432 ◽  
Author(s):  
Anne-Sophie Gillioz ◽  
Hélène Villars ◽  
Thierry Voisin ◽  
Frédéric Cortes ◽  
Sophie Gillette-Guyonnet ◽  
...  

2009 ◽  
Vol 5 (4S_Part_17) ◽  
pp. e28-e28
Author(s):  
Michael Ewers ◽  
Cathal Walsh ◽  
John Q. Trojanowski ◽  
Leslie M. Shaw ◽  
Philip Sheltens ◽  
...  

2019 ◽  
Vol 5 (4) ◽  
pp. 76-102 ◽  
Author(s):  
A. Volobuev ◽  
P. Romanchuk

Modern rational pharmacotherapy allows being provided with a balance of efficacy and safety in clinical geriatrics, which is especially important in patients with neurovascular degeneration, including in the presence of severe forms of vascular comorbidity, requiring multi–component therapy, under the condition of active multidisciplinary and interdepartmental impact. Dementia in its origin is mixed and it is extremely difficult to divide into parts its primary degenerative or vascular component. The differentiated approach is determined by the heterogeneity of the pathological process, which common is the relationship of cerebral vascular damages with the development of the brain symptoms damage. The problem of nosological independence of Alzheimer’s disease is the subject of discussion for patients of older age groups (especially in people 65 years and older). The genesis of mnestic–intellectual disorders is due not so much to primary–degenerative as vascular changes, especially at the level of the microcirculatory canal. The modern problem of neurodegeneration has a neurophysiological, biophysical, gerontological, geriatric and strategic practical orientation since the diagnosis of the cause of the disease determines the choice of adequate treatment. Due to a large number of pathogenetical mechanisms, there is no single and standardized method of treatment for vascular dementia and Alzheimer’s disease. In any case, prevention of the development and progression of vascular dementia and Alzheimer’s disease should take into account the etiological mechanisms of its occurrence, because it will vary in patients with failures of small vessels, occlusive damages of the main arteries of the head or an embolism of cardiogenic origin. In patients with failures of small vessels, the main direction of therapy should be the normalization of blood pressure, which leads to improved cognitive functions. At the same time, excessive lowering of blood pressure can provoke an increase in mnestic-intellectual disorders, possibly caused by a secondary decrease in cerebral blood flow due to a violation of autoregulation. Biophysics of blood circulation in Alzheimer’s disease is characterized by disorders of laminar blood flow and cerebral hypoperfusion. As a result, failure intracellular metabolism, there is a cascade of changes in neurons associated with the processes of excitotoxicity and oxidant stress, which in turn stimulates amyloidogenesis. Experimental and 25-year observations have shown that the long–existing state of hypoperfusion leads to hippocampal disorders. This process is accompanied by memory impairment, structural changes in the capillaries in the hippocampus, impaired glucose and protein metabolism, β–amyloid deposition, activation of glial tissue, the death of hippocampal neurons.


2015 ◽  
Vol 36 ◽  
pp. S194-S202 ◽  
Author(s):  
Christina P. Boyle ◽  
Cyrus A. Raji ◽  
Kirk I. Erickson ◽  
Oscar L. Lopez ◽  
James T. Becker ◽  
...  

1997 ◽  
Vol 170 (6) ◽  
pp. 580-580 ◽  
Author(s):  
G. R. J. Swanwick ◽  
M. J. Rowan ◽  
R. F. Coen ◽  
B. A. Lawlor ◽  
D. Coakley

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