A US prospective clinical-pathologic study revealed that late in life both higher average and faster decline in blood pressure (BP) are related to cardiovascular and/or Alzheimer disease (AD). The study included 1,288 persons (mean age at death = 88.6 years; 65% women, mean follow-up 8 years). Each participant had BP measured yearly and brain autopsy after death, the mean standardized person-specific systolic BP (SBP) across the study was 134 (SD = 13) and diastolic BP (DBP) was 71 (SD = 8) mm Hg. The odds of brain infarcts were increased for participants with a higher mean SBP. Specifically, a person with a 1 SD SBP above the mean (147 vs 134 mm Hg) would have a 46% increased odds of having one or more infarcts, and an increased odds of gross infarct (46%) and microinfarct (36%). Furthermore, a more rapidly declining SBP slope over time increased the odds of one or more infarcts. Mean DBP, not slope, was related to brain infarcts. A higher mean SBP was associated with higher number of tangles but not plaques or other AD pathology. Changes in BP were not significantly related to AD pathology. The study confirms high BP is bad for the brain and adds to a growing number of studies showing decline in BP may be also detrimental late in life. Source: http://n.neurology.org/
