| Background: Hypertension is a common risk factor for vascular disease and plays an important role in Alzheimer’s disease(AD).Dementia is divided into different subtypes,each subtype of pathogenesis is very complex,AD is the most common clinical subtypes in all subtypes.Although in the past few decades,the studies about the association between blood pressure and AD have greatly improved,there are still a lot of controversy between blood pressure and dementia,it is not clear whether the hypertension is a risk factor of AD.Objective: The aim of this study was to analyze the relationship between blood pressure,values of blood pressure and cerebrospinal fluid(CSF)biomarkers in AD,to reflect the association between blood pressure and AD,and to provide evidence for prevention and treatment of AD.Methods: A total of 786 participants were included in this study from the Chinese Alzheimer’s Disease Biomarker and Lifestyl E(CABLE)research database.The AD biomarkers included cerebrospinal fluid β-amyloid(Aβ),total tau(t-tau)and phosphorylated tau(p-tau)in this study.The original data were made into normal distribution through logarithmic transformation and other methods.Participants were divided into hypertensive group and non-hypertensive group according to whether the patients had hypertension or not.First,univariate analysis was conducted for the data between the two groups,in which the measurement data conforming to the normal distribution was tested by t test,and the counting data by chi-square test.According to the results of univariate analysis,the total population was divided into the middle-aged group(<65 years old)and the older group(≥65 years old),and the relationship between the history of hypertension and AD biomarkers in each group was determined by multiple linear regression analysis.Secondly,the systolic blood pressure(SBP)and diastolic blood pressure(DBP)were measured for the first time on admission,were also collected to further verify the relationship between blood pressure and CSF biomarkers of AD.In addition,in all studies,we adjusted for age,sex,years of education,and APOE ε4 carrier status to exclude confounding factors.Results: In the general population,t-tau(p =0.032)and p-tau(p =0.015)in cerebrospinal fluid of hypertensive patients were higher than those of non-hypertensive patients.There was no significant difference in the level of Aβ between the hypertensive group and the non-hypertensive group(p =0.969).Increased DBP was significantly associated with decreased t-tau levels(p =0.035)and p-tau levels(p=0.025),while no such correlation was found in systolic blood pressure.In further subgroup analysis.CSF t-tau(p <0.001)and ptau(p <0.001)levels were higher in patients with hypertension in the middle age group than those without a history of hypertension,while there was no statistically significant difference in CSF biomarkers of AD between the hypertensive group and the nonhypertensive group in the older group.Second,higher values of SBP were associated with higher t-tau(p =0.008)and p-tau(p =0.033)in the middle-aged group,but not in the older group(over 65 years of age).While higher DBP was associated with lower t-tau(p <0.001)and p-tau(p <0.001)in the older group,no correlation was found in the middle age group.Conclusion: In cognitively normal middle-aged and older adults,especially in middle age,hypertension is associated with levels of t-tau and p-tau in the cerebrospinal fluid.In addition,SBP and DBP may also play different roles in CSF biomarkers of AD at different age stages.It suggests that we should adjust hypotensive strategies according to the characteristics of different populations in clinical work,and do a good job in the early prevention and treatment of AD. |
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