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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Associations of Blood Pressure with Functional and Cognitive Changes in Patients with Alzheimer's Disease

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Author(s):
de Oliveira, Fabricio Ferreira ; Chen, Elizabeth Suchi ; Smith, Marilia Cardoso ; Ferreira Bertolucci, Paulo Henrique
Total Authors: 4
Document type: Journal article
Source: DEMENTIA AND GERIATRIC COGNITIVE DISORDERS; v. 41, n. 5-6, p. 314-323, 2016.
Web of Science Citations: 7
Abstract

Background: Midlife hypertension followed by late life hypotension resulting from neurodegeneration increases amyloidogenesis and tauopathy. Methods: Consecutive outpatients with late-onset Alzheimer's disease (AD) at various stages and their respective caregivers were assessed for score variations in 1 year of tests assessing caregiver burden, functionality and cognition according to blood pressure (BP) variations and APOE haplotypes, while also taking into account differential effects of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, diuretics, or no antihypertensive medication on score changes. The diagnosis and treatment of arterial hypertension followed the JNC 7 report. Results: Variations in systolic BP (-11.76 +/- 17.1 mm Hg), diastolic BP (-4.92 +/- 10.3 mm Hg) and pulse pressure (-6.84 +/- 12.6 mm Hg) were significant after 1 year (n = 191;. < 0.01). For APOE4+ carriers, rises in systolic or diastolic BP improved Clinical Dementia Rating Scale Sum of Boxes scores (rho < 0.04), with marginally significant improvements in MiniMental State Examination scores resulting from risen systolic (rho = 0.069) or diastolic BP (. = 0.079), and in basic independence only regarding risen diastolic BP (rho = 0.055). APOE4-carriers resisted any functional or cognitive effects of BP variations. No differences were found regarding any antihypertensive class for variations in BP or any test scores, regardless of APOE haplotypes. Conclusions: Targeting mild BP elevations brings better functional and cognitive results for APOE4+ carriers with AD. (C) 2016 S. Karger AG, Basel (AU)

FAPESP's process: 15/10109-5 - Comparative analysis of cerebrospinal fluid and serum markers in dementia with Lewy Bodies and Alzheimer's Disease dementia
Grantee:Fabricio Ferreira de Oliveira
Support Opportunities: Scholarships in Brazil - Post-Doctoral