Extremely low diastolic blood pressure (≤65 mm Hg) was associated with an increased risk of incident dementia compared to 66-90 mm Hg (RR 1.5; 95% CI 1.0-2.1; P=0.03).
Cohort (n=1,270)
Does low or high blood pressure increase the risk of incident dementia and Alzheimer disease in elderly people?
Both low diastolic and high systolic blood pressure are associated with an increased risk of incident Alzheimer disease and dementia in the elderly.
Relative Risk: 1.5 (95% CI 1–2.1)
p-value: p=0.03
BACKGROUND: Previous studies have reported a higher prevalence of dementia in persons with low blood pressure. OBJECTIVE: To examine whether low blood pressure is prospectively associated with the occurrence of Alzheimer disease and dementia in elderly people. SUBJECTS AND METHODS: A community-based, dementia-free cohort (n = 1270) aged 75 to 101 years was longitudinally examined twice within 6 years to detect incident dementia using the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria. Cox proportional hazards models were used to analyze blood pressure in association with dementia after adjustment for several potential confounders. RESULTS: During the 6-year period, 339 subjects were diagnosed with dementia, including 256 persons with Alzheimer disease. Subjects with very high systolic pressure (>180 vs 141-180 mm Hg) had an adjusted relative risk of 1.5 (95% confidence interval CI, 1.0-2.3; P =.07) for Alzheimer disease, and 1.6 (95% CI, 1.1-2.2) for dementia. Low systolic pressure (90 mm Hg) was not associated with dementia incidence, whereas extremely low diastolic pressure (</=65 vs 66-90 mm Hg) produced an adjusted relative risk of 1.7 (95% CI, 1.1-2.4) for Alzheimer disease and 1.5 (95% CI, 1.0-2.1; P =.03) for dementia. The latter association was pronounced particularly in persons who used antihypertensive drugs. CONCLUSIONS: Both low diastolic and high systolic pressure are associated with an increased risk of Alzheimer disease and dementia in this elderly population. The atherosclerotic process may explain the observed associations. In addition, low diastolic pressure may increase dementia risk by affecting cerebral perfusion.
Qiu et al. (2003) conducted a cohort in Dementia (n=1,270). Extremely low diastolic blood pressure (≤65 mm Hg) vs. Diastolic blood pressure 66-90 mm Hg was evaluated on Incident dementia (RR 1.5, 95% CI 1.0-2.1, p=0.03). Extremely low diastolic blood pressure (≤65 mm Hg) was associated with an increased risk of incident dementia compared to 66-90 mm Hg (RR 1.5; 95% CI 1.0-2.1; P=0.03).