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Higher Pulse Pressure Tied To Dementia Risks
A DGReview of :"Pulse pressure and risk of Alzheimer disease in persons aged 75 years and older: a community-based, longitudinal study"
Stroke
03/17/2003
By Anne MacLennan
Higher pulse pressure in older adults is linked with increased risk for Alzheimer disease (AD) and dementia, which is probably caused by artery stiffness and severe atherosclerosis.
The association between lower pulse pressure and increased dementia risk may be explained by poor cerebral perfusion related to decreased pulse pressure explain Dr C Qiu and colleagues from the Karolinska Institute, Stockholm, Sweden. They make offer this suggestion following a longitudinal study of pulse pressure and AD risk in a cohort of 1,270 people, aged 75 years or more.
The increased risk of dementia, including AD, with elevated blood pressure prompted the investigators to study whether pulse pressure might be predictive of these conditions. They clinically examined study participants, all of them living in the community and dementia free at study outset, twice over a period of six years (Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition).
After considering several potential confounders, including systolic pressure and diastolic pressure, they analysed pulse pressure in relation to AD and dementia by Cox proportional hazards model.
In a median 4.7 years of follow-up (a total of 5,464.6 person-years), 339 people developed dementia. Of these, 256 were AD cases.
Pulse pressure as a continuous variable was not statistically related to the risk of either AD or dementia. However, in the categorical analysis, as compared with the median tertile of pulse pressure (70 mm Hg to 84 mm Hg), those with higher pulse pressure had adjusted relative risks of 1.4 for AD and 1.3 for dementia.
The corresponding figures related to lower pulse pressure were 1.7 for AD and 1.4 for dementia. This association was particularly pronounced among women, the authors note.
Stroke 2003 Mar;34:3:594-9.
"Pulse pressure and risk of Alzheimer disease in persons aged 75 years and older: a community-based, longitudinal study"
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