Key result
Midlife high blood pressure at a single timepoint significantly increased the risk for all-cause dementia (HR 1.22) and more than doubled the risk for vascular dementia (HR 2.10) later in life.
Why the study?
While midlife hypertension is an established risk factor for late-life dementia, it was unknown whether high blood pressure at a single midlife timepoint can predict dementia, Alzheimer's disease, or vascular dementia.
Does high blood pressure at a single timepoint in midlife predict an increased risk for all-cause dementia, Alzheimer's disease, or vascular dementia later in life in adults aged 40-50?
Cohort (n=30,102)
Does high blood pressure at a single timepoint in midlife predict an increased risk for all-cause dementia, Alzheimer's disease, or vascular dementia later in life in adults aged 40-50?
Hazard Ratio: 1.22 (95% CI 1.02–1.45)
p-value: p=0.026
A single measurement of high blood pressure in midlife independently predicts all-cause dementia and more than doubles the risk for vascular dementia later in life, highlighting the importance of midlife screening.
Single midlife BP reading may flag later dementia risk; leaves open whether screening or intervention alters outcomes.
BACKGROUND: There is substantial evidence that midlife hypertension is a risk factor for late life dementia. Our aim was to investigate if even high blood pressure at a single timepoint in midlife can predict an increased risk for all-cause dementia, Alzheimer's disease (AD), or vascular dementia (VaD) later in life. METHODS: . The participants were aged 40 or 50 years when the health examination took place in 1990-2000. Diagnose registers from both hospitals and primary healthcare centers were used to identify individuals who after inclusion to the study developed dementia. The association between midlife high blood pressure (defined as systolic blood pressure >140 and/or diastolic blood pressure >90 mmHg) at a single timepoint and dementia was adjusted for age, gender, body mass index (BMI), fasting blood glucose, education, smoking, and physical activity level. Multivariate binary cox regression analyses were used. RESULTS: After a mean follow-up time of 24 years resulting in 662,244 person/years, 761 (2.5%) individuals had been diagnosed with dementia. Midlife high blood pressure at a single timepoint predicted all-cause dementia (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.02-1.45) and VaD (HR: 2.10, 95% CI: 1.47-3.00) but not AD (HR: 1.06, 95% CI: 0.81-1.38). CONCLUSION: This study suggests that even midlife high blood pressure at a single timepoint predicts all-cause dementia and more than doubles the risk for VaD later in life independently of established confounders. Even though there was no such association with AD, this strengthens the importance of midlife health examinations in order to identify individuals with hypertension and initiate treatment.
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Moberg et al. (2022) conducted a cohort in Dementia (n=30,102). Midlife high blood pressure (SBP >140 and/or DBP >90 mmHg) vs. Non-high blood pressure (SBP ≤140 and DBP ≤90 mmHg) was evaluated on All-cause dementia (HR 1.22, 95% CI 1.02-1.45, p=0.026). Midlife high blood pressure at a single timepoint significantly increased the risk for all-cause dementia (HR 1.22) and more than doubled the risk for vascular dementia (HR 2.10) later in life.
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