We read with great interest the article by McGrath et al. which reported a significant association between elevated mid-life blood pressure (BP), persistent late-life BP, steep mid-to-late life BP decline, and risk of dementia, and underscored the vascular contribution to cognitive dysfunction. [1] Nonetheless, since the exact role of vascular disease in the pathophysiology of Alzheimer disease (AD) and non-AD dementias remains unclear, the analysis of reliable hemodynamic parameters further to BP trajectories alone (as the pulsatile component of BP through pulse pressure, [2] and the BP variability through average real variability, [3-5] which accounts for the order of BP measurements over time, or residual standard deviation, which takes account of temporal trends in BP), may provide a more nuanced perspective of the mechanisms linking vascular aging to neurodegeneration, and add useful insights toward potential future therapeutic horizons.
1. McGrath ER, Beiser AS, DeCarli C, et al. Blood pressure from mid- to late life and risk of incident dementia. Neurology Epub 2017 Nov 8.
2. Nation DA, Edmonds EC, Bangen KJ, et al. Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol 2015;72:546-553.
5. Lattanzi S, Luzzi S, Provinciali L, Silvestrini M. Blood pressure variability in Alzheimer's disease and frontotemporal dementia: the effect on the rate of cognitive decline. J Alzheimers Dis 2015;45:387-394.
For disclosures, please contact the editorial office at [email protected].
We read with great interest the article by McGrath et al. which reported a significant association between elevated mid-life blood pressure (BP), persistent late-life BP, steep mid-to-late life BP decline, and risk of dementia, and underscored the vascular contribution to cognitive dysfunction. [1] Nonetheless, since the exact role of vascular disease in the pathophysiology of Alzheimer disease (AD) and non-AD dementias remains unclear, the analysis of reliable hemodynamic parameters further to BP trajectories alone (as the pulsatile component of BP through pulse pressure, [2] and the BP variability through average real variability, [3-5] which accounts for the order of BP measurements over time, or residual standard deviation, which takes account of temporal trends in BP), may provide a more nuanced perspective of the mechanisms linking vascular aging to neurodegeneration, and add useful insights toward potential future therapeutic horizons.
1. McGrath ER, Beiser AS, DeCarli C, et al. Blood pressure from mid- to late life and risk of incident dementia. Neurology Epub 2017 Nov 8.
2. Nation DA, Edmonds EC, Bangen KJ, et al. Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol 2015;72:546-553.
3. Lattanzi S, Viticchi G, Falsetti L, et al. Visit-to-visit blood pressure variability in Alzheimer disease. Alzheimer Dis Assoc Disord 2014;28:347-351.
4. Lattanzi S, Luzzi S, Provinciali L, Silvestrini M. Blood pressure variability predicts cognitive decline in Alzheimer's disease patients. Neurobiol Aging 2014;35:2282-2287.
5. Lattanzi S, Luzzi S, Provinciali L, Silvestrini M. Blood pressure variability in Alzheimer's disease and frontotemporal dementia: the effect on the rate of cognitive decline. J Alzheimers Dis 2015;45:387-394.
For disclosures, please contact the editorial office at [email protected].