Abstract
The associations between blood pressure and dementia have been inconclusive. We followed up a total of 668 community-dwelling Japanese individuals without dementia, aged 65 to 79 years, for 17 years and examined the associations of late-life and midlife hypertension with the risk of vascular dementia and Alzheimer disease using the Cox proportional hazards model. During the follow-up, 76 subjects experienced vascular dementia and 123 developed Alzheimer disease. The age- and sex-adjusted incidence of vascular dementia significantly increased with elevated late-life blood pressure levels (normal: 2.3, prehypertension: 8.4, stage 1 hypertension: 12.6, and stage 2 hypertension: 18.9 per 1000 person-years; Ptrend<0.001), whereas no such association was observed for Alzheimer disease (Ptrend=0.88). After adjusting for potential confounding factors, subjects with prehypertension and stage 1 or stage 2 hypertension had 3.0-fold, 4.5-fold, and 5.6-fold greater risk of vascular dementia, respectively, compared with subjects with normal blood pressure. Likewise, there was a positive association of midlife blood pressure levels with the risk of vascular dementia but not with the risk of Alzheimer disease. Compared with those without hypertension in both midlife and late life, subjects with midlife hypertension had an ≈5-fold greater risk of vascular dementia, regardless of late-life blood pressure levels. Our findings suggest that midlife hypertension and late-life hypertension are significant risk factors for the late-life onset of vascular dementia but not for that of Alzheimer disease in a general Japanese population. Midlife hypertension is especially strongly associated with a greater risk of vascular dementia, regardless of late-life blood pressure levels.
| Original language | English |
|---|---|
| Pages (from-to) | 22-28 |
| Number of pages | 7 |
| Journal | Hypertension |
| Volume | 58 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 1 2011 |
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All Science Journal Classification (ASJC) codes
- Internal Medicine
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Midlife and late-life blood pressure and dementia in japanese elderly : The hisayama study. / Ninomiya, Toshiharu; Ohara, Tomoyuki; Hirakawa, Yoichiro; Yoshida, Daigo; Doi, Yasufumi; Hata, Jun; Kanba, Shigenobu; Iwaki, Toru; Kiyohara, Yutaka.
In: Hypertension, Vol. 58, No. 1, 01.07.2011, p. 22-28.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Midlife and late-life blood pressure and dementia in japanese elderly
T2 - The hisayama study
AU - Ninomiya, Toshiharu
AU - Ohara, Tomoyuki
AU - Hirakawa, Yoichiro
AU - Yoshida, Daigo
AU - Doi, Yasufumi
AU - Hata, Jun
AU - Kanba, Shigenobu
AU - Iwaki, Toru
AU - Kiyohara, Yutaka
PY - 2011/7/1
Y1 - 2011/7/1
N2 - The associations between blood pressure and dementia have been inconclusive. We followed up a total of 668 community-dwelling Japanese individuals without dementia, aged 65 to 79 years, for 17 years and examined the associations of late-life and midlife hypertension with the risk of vascular dementia and Alzheimer disease using the Cox proportional hazards model. During the follow-up, 76 subjects experienced vascular dementia and 123 developed Alzheimer disease. The age- and sex-adjusted incidence of vascular dementia significantly increased with elevated late-life blood pressure levels (normal: 2.3, prehypertension: 8.4, stage 1 hypertension: 12.6, and stage 2 hypertension: 18.9 per 1000 person-years; Ptrend<0.001), whereas no such association was observed for Alzheimer disease (Ptrend=0.88). After adjusting for potential confounding factors, subjects with prehypertension and stage 1 or stage 2 hypertension had 3.0-fold, 4.5-fold, and 5.6-fold greater risk of vascular dementia, respectively, compared with subjects with normal blood pressure. Likewise, there was a positive association of midlife blood pressure levels with the risk of vascular dementia but not with the risk of Alzheimer disease. Compared with those without hypertension in both midlife and late life, subjects with midlife hypertension had an ≈5-fold greater risk of vascular dementia, regardless of late-life blood pressure levels. Our findings suggest that midlife hypertension and late-life hypertension are significant risk factors for the late-life onset of vascular dementia but not for that of Alzheimer disease in a general Japanese population. Midlife hypertension is especially strongly associated with a greater risk of vascular dementia, regardless of late-life blood pressure levels.
AB - The associations between blood pressure and dementia have been inconclusive. We followed up a total of 668 community-dwelling Japanese individuals without dementia, aged 65 to 79 years, for 17 years and examined the associations of late-life and midlife hypertension with the risk of vascular dementia and Alzheimer disease using the Cox proportional hazards model. During the follow-up, 76 subjects experienced vascular dementia and 123 developed Alzheimer disease. The age- and sex-adjusted incidence of vascular dementia significantly increased with elevated late-life blood pressure levels (normal: 2.3, prehypertension: 8.4, stage 1 hypertension: 12.6, and stage 2 hypertension: 18.9 per 1000 person-years; Ptrend<0.001), whereas no such association was observed for Alzheimer disease (Ptrend=0.88). After adjusting for potential confounding factors, subjects with prehypertension and stage 1 or stage 2 hypertension had 3.0-fold, 4.5-fold, and 5.6-fold greater risk of vascular dementia, respectively, compared with subjects with normal blood pressure. Likewise, there was a positive association of midlife blood pressure levels with the risk of vascular dementia but not with the risk of Alzheimer disease. Compared with those without hypertension in both midlife and late life, subjects with midlife hypertension had an ≈5-fold greater risk of vascular dementia, regardless of late-life blood pressure levels. Our findings suggest that midlife hypertension and late-life hypertension are significant risk factors for the late-life onset of vascular dementia but not for that of Alzheimer disease in a general Japanese population. Midlife hypertension is especially strongly associated with a greater risk of vascular dementia, regardless of late-life blood pressure levels.
UR - http://www.scopus.com/inward/record.url?scp=79959704345&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79959704345&partnerID=8YFLogxK
U2 - 10.1161/HYPERTENSIONAHA.110.163055
DO - 10.1161/HYPERTENSIONAHA.110.163055
M3 - Article
C2 - 21555680
AN - SCOPUS:79959704345
VL - 58
SP - 22
EP - 28
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 1
ER -