Given the devastating toll of Alzheimer’s disease and the expectation that cases and deaths from the disease will continue to rise as the elderly population grows in the U.S., researchers focus significant effort toward improving our understanding of the disease and finding new ways for physicians to treat it. Thus far, no disease-modifying therapy for Alzheimer’s disease has been discovered.
One key research strategy in Alzheimer’s disease is identifying biomarkers of Alzheimer’s disease so that more targeted treatments can be developed and so they can be deployed as early on in the progression of the disease as possible. A relevant area of inquiry has been hypertension, as there has been some thought that blood pressure intervention may affect the disease.
Unfortunately, a new study published in JAMA Neurology has failed to identify a clear relationship between hypertension management and Alzheimer’s disease risk. The researchers found that the only biomarker of Alzheimer’s disease that intensive blood pressure reduction in hypertension was associated with was greater hippocampal volume changes. However, this type of change in blood pressure was not found to affect any other MRI biomarkers for the disease.
Previously, a trial known as the SPRINT MIND trial had found that intensive control of blood pressure did not significantly affect the primary outcomes in people with hypertension and probable dementia but did reduce risk for secondary outcomes. The details of this trial suggested that if intensive hypertension control were to reduce the risk of Alzheimer’s disease or improve outcomes in Alzheimer’s disease patients, it likely did so by improving the risk of cardiovascular events.
More research is needed to better understand the relationship between hypertension and Alzheimer’s disease and to provide actionable information on how to address each of these conditions, as well as when they co-occur. New data will help to clarify whether controlling blood pressure may provide benefits in the realm of Alzheimer’s disease – and, if so – how.
Landau, S.M. & Harrison, T.M.. (2021). A link between cardiovascular risk management and Alzheimer disease is still elusive. JAMA Neurology, doi:10.1001/jamaneurol.2021.0083