PT  - JOURNAL ARTICLE
AU  - Nation, Daniel A.
AU  - Edland, Steven D.
AU  - Bondi, Mark W.
AU  - Salmon, David P.
AU  - Delano-Wood, Lisa
AU  - Peskind, Elaine R.
AU  - Quinn, Joseph F.
AU  - Galasko, Douglas R.
TI  - Pulse pressure is associated with Alzheimer biomarkers in cognitively normal older adults
AID  - 10.1212/01.wnl.0000436935.47657.78
DP  - 2013 Dec 03
TA  - Neurology
PG  - 2024--2027
VI  - 81
IP  - 23
4099  - http://n.neurology.org/content/81/23/2024.short
4100  - http://n.neurology.org/content/81/23/2024.full
SO  - Neurology2013 Dec 03; 81
AB  - Objective: The current study examined the association between pulse pressure (PP) and CSF-based biomarkers for Alzheimer disease, including β-amyloid 1–42 (Aβ1–42) and phosphorylated tau (P-tau) protein, in cognitively normal older adults.Methods: One hundred seventy-seven cognitively normal, stroke-free older adult participants (aged 55–100 years) underwent blood pressure assessment for determination of PP (systolic − diastolic blood pressure) and lumbar puncture for measurement of CSF Aβ1–42 and P-tau. Pearson correlations and multiple linear regression, controlling for age, sex, APOE genotype, and body mass index, evaluated the relationship between PP and Alzheimer disease biomarkers.Results: PP elevation was associated with increased P-tau (r = 0.23, p = 0.002), reduced Aβ1–42 (r = −0.19, p = 0.01), and increased P-tau to Aβ1–42 ratio (r = 0.27, p < 0.001). After controlling for covariates, PP remained associated with P-tau (β = 0.18, p = 0.0196) and P-tau to Aβ1–42 ratio (β = 0.0016, p < 0.001) but was no longer associated with Aβ1–42 (β = −0.1, p = 0.35). Post hoc multivariate analyses indicated that increased PP was associated with all biomarkers in younger participants (aged 55–70 years) (Aβ1–42: p = 0.050; P-tau: p = 0.003; P-tau to Aβ ratio: p = 0.0007) but not older participants (aged 70–100 years).Conclusions: PP elevation is associated with increased CSF P-tau and decreased Aβ1–42 in cognitively normal older adults, suggesting that pulsatile hemodynamics may be related to amyloidosis and tau-related neurodegeneration. The relationship between PP and CSF biomarkers is age-dependent and observed only in participants in the fifth and sixth decades of life.Aβ1–42=β-amyloid 1–42; AD=Alzheimer disease; BMI=body mass index; BP=blood pressure; PP=pulse pressure; P-tau=phosphorylated tau; UCSD=University of California, San Diego