Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
    • UDDA Revision Series
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Education
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Online Sections
    • Neurology Video Journal Club
    • Diversity, Equity, & Inclusion (DEI)
    • Neurology: Clinical Practice Accelerator
    • Practice Buzz
    • Practice Current
    • Residents & Fellows
    • Without Borders
  • Collections
    • COVID-19
    • Disputes & Debates
    • Health Disparities
    • Infographics
    • Neurology Future Forecasting Series
    • Null Hypothesis
    • Patient Pages
    • Topics A-Z
    • Translations
    • UDDA Revision Series
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit New Manuscript
    • Submit Revised Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Neurology Video Journal Club
  • Residents & Fellows

Share

December 12, 2017; 89 (24) Article

Blood pressure from mid‐ to late life and risk of incident dementia

Emer R. McGrath, Alexa S. Beiser, Charles DeCarli, Kendra L. Plourde, Ramachandran S. Vasan, Steven M. Greenberg, Sudha Seshadri
First published November 8, 2017, DOI: https://doi.org/10.1212/WNL.0000000000004741
Emer R. McGrath
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MB, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alexa S. Beiser
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Charles DeCarli
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kendra L. Plourde
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MA
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Ramachandran S. Vasan
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Steven M. Greenberg
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MD, PhD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sudha Seshadri
From the Department of Neurology (E.R.M.), Brigham & Women's Hospital; Department of Neurology (E.R.M., S.M.G.), Massachusetts General Hospital; Harvard Medical School (E.R.M., S.M.G.); Boston University School of Medicine (A.S.B., R.S.V., S.S.); Boston University School of Public Health (A.S.B., K.L.P., R.S.V.); Framingham Heart Study (A.S.B., R.S.V., S.S.), MA; and 7Department of Neurology (C.D.), University of California, Davis.
MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Full PDF
Citation
Blood pressure from mid‐ to late life and risk of incident dementia
Emer R. McGrath, Alexa S. Beiser, Charles DeCarli, Kendra L. Plourde, Ramachandran S. Vasan, Steven M. Greenberg, Sudha Seshadri
Neurology Dec 2017, 89 (24) 2447-2454; DOI: 10.1212/WNL.0000000000004741

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
423

Share

  • Article
  • Figures & Data
  • Info & Disclosures
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Abstract

Objective: To determine the association between blood pressure during midlife (40–64 years) to late life (≥65 years) and risk of incident dementia.

Methods: This study included 1,440 (758 women, mean age 69 ± 6 years) Framingham Offspring participants who were free of dementia and attended 5 consecutive examinations at 4-year intervals starting at midlife (1983–1987, mean age 55 years) until late life (1998–2001, mean 69 years) and subsequently were followed up for incident dementia (mean 8 years). We determined the effect of midlife hypertension (≥140/90 mm Hg), late life hypertension, lower late life blood pressure (<100/70 mm Hg), persistence of hypertension during mid- to late life, and steep decline in blood pressure from mid- to late life over an 18-year exposure period.

Results: During the follow-up period, 107 participants (71 women) developed dementia. Using multivariable Cox proportional hazards models, we found that midlife systolic hypertension (hazard ratio [HR] 1.57, 95% confidence interval [CI] 1.05–2.35) and persistence of systolic hypertension into late life (HR 1.96, 95% CI 1.25–3.09) were associated with an elevated risk of incident dementia. However, in individuals with low to normal blood pressure (≤140/90 mm Hg) at midlife, a steep decline in systolic blood pressure during mid- to late life was also associated with a >2-fold increase in dementia risk (HR 2.40, 95% CI 1.39–4.15).

Conclusions: Elevated blood pressure during midlife, persistence of elevated blood pressure into late life, and, among nonhypertensives, a steep decline in blood pressure during mid- to late life were associated with an increased dementia risk in a community-based cohort. Our data highlight the potential sustained cognitive benefits of lower blood pressures in midlife but also suggest that declining blood pressure in older adults with prehypertension or normotension, but not in those with hypertension, may be a risk marker for dementia.

GLOSSARY

AD=
Alzheimer disease;
AUC=
area under the curve;
BP=
blood pressure;
CBI=
covert brain infarct;
CI=
confidence interval;
DBP=
diastolic blood pressure;
DSM-IV=
Diagnostic and Statistical Manual of Mental Disorders, 4th edition;
HR=
hazard ratio;
HV=
hippocampal volume;
JNC-7=
Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure 7;
PROGRESS=
Perindopril Protection Against Recurrent Stroke Study;
SBP=
systolic blood pressure;
Syst-Eur=
Systolic Hypertension in Europe;
TCBV=
total cerebral brain volume;
WMHV=
white matter hyperintensity volume

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Supplemental data at Neurology.org

  • Received April 27, 2017.
  • Accepted in final form September 18, 2017.
  • © 2017 American Academy of Neurology
View Full Text

AAN Members

We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.

Google Safari Microsoft Edge Firefox

Click here to login

AAN Non-Member Subscribers

Click here to login

Purchase access

For assistance, please contact:
AAN Members (800) 879-1960 or (612) 928-6000 (International)
Non-AAN Member subscribers (800) 638-3030 or (301) 223-2300 option 3, select 1 (international)

Sign Up
Information on how to subscribe to Neurology and Neurology: Clinical Practice can be found here 

Purchase
Individual access to articles is available through the Add to Cart option on the article page.  Access for 1 day (from the computer you are currently using) is US$ 39.00.  Pay-per-view content is for the use of the payee only, and content may not be further distributed by print or electronic means.  The payee may view, download, and/or print the article for his/her personal, scholarly, research, and educational use.  Distributing copies (electronic or otherwise) of the article is not allowed.

Letters: Rapid online correspondence

  • Author response to Drs. Lattanzi, Silvestrini, and Ganesh
    • Emer R. McGrath, Clinical Fellow in Neurology, Brigham & Women's Hospital; Massachusetts General Hospital; Harvard Medical School
    • Sudha Seshadri, Professor of Neurology, Boston University School of Medicine
    Submitted March 20, 2018
  • Blood pressure and dementia in the 21st century: The need for home-based monitoring
    • Aravind Ganesh, Neurology Resident, Stroke Fellow, University of Calgary; University of Oxfordaravindganeshy@yahoo.ca
    Submitted January 03, 2018
  • Blood pressure trajectories and dementia risk
    • Simona Lattanzi, Marche Polytechnic Universityalfierelattanzisimona@gmail.com
    • Mauro Silvestrini, Ancona, Italy
    Submitted November 17, 2017
Comment

REQUIREMENTS

You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.

Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.

If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.

Submission specifications:

  • Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
  • Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
  • Submit only on articles published within 6 months of issue date.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Publishing Agreement Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
    • Abstract
    • GLOSSARY
    • METHODS
    • RESULTS
    • DISCUSSION
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • Footnotes
    • REFERENCES
  • Figures & Data
  • Info & Disclosures
Advertisement

Differentiating Multiple Sclerosis From AQP4-Neuromyelitis Optica Spectrum Disorder and MOG-Antibody Disease With Imaging

Dr. Ann Yeh and Dr. Daniela Castillo Villagrán

► Watch

Topics Discussed

  • All Cognitive Disorders/Dementia
  • Cohort studies
  • Risk factors in epidemiology
  • Cognitive aging

Alert Me

  • Alert me when eletters are published

Recommended articles

  • Article
    NT-proBNP, blood pressure, and cognitive decline in the oldest old
    The Leiden 85-plus Study
    Peter van Vliet, Behnam Sabayan, Liselotte W. Wijsman et al.
    Neurology, August 20, 2014
  • Articles
    Midlife cardiovascular risk factors and risk of dementia in late life
    R. A. Whitmer, S. Sidney, J. Selby et al.
    Neurology, January 24, 2005
  • Articles
    Duration of antihypertensive drug use and risk of dementia
    A prospective cohort study
    M.D.M. Haag, A. Hofman, P. J. Koudstaal et al.
    Neurology, February 18, 2009
  • Article
    Female sex, early-onset hypertension, and risk of dementia
    Paola Gilsanz, Elizabeth Rose Mayeda, M. Maria Glymour et al.
    Neurology, October 04, 2017
Neurology: 101 (12)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Education
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2023 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise