Understanding Pulse Pressure, Biomarkers, and Dementia

Elevated pulse pressure is associated with neurodegenerative changes prior to the onset of dementia, a retrospective cohort study of 877 adults without dementia in the Alzheimer’s Disease Neuroimaging Initiative found.

Subjects aged 55 to 91 years old underwent a baseline health assessment that included blood pressure measurements and lumbar puncture for biomarkers phosphorylated tau (P-tau) and b-amyloid 1-42. Researchers tracked subjects for progression to dementia for 6 to 96 months and found:

• Regardless of age, all P-tau–positive subjects had elevated pulse pressure.

• Subjects 80 years and older with both elevated P-tau and reduced b-amyloid 1-42 had an even greater increase in pulse pressure, compared to peers without or with only 1 biomarker.

• Higher baseline pulse pressure was associated with a more rapid progression to dementia.

Citation: Nation DA, Edmonds EC, Bangen KJ, et al; Alzheimer’s Disease Neuroimaging Initiative Investigators. Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol. 2015. doi: 10.1001/jamaneurol.2014.4477.