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Martha Clare Morris, ScD; Paul A. Scherr, PhD, ScD; Liesi E. Hebert, ScD; Robert J. Glynn, PhD; David A. Bennett, MD; Denis A. Evans, MD

Arch Neurol. 2001;58:1640-1646.

Background  It is uncertain whether high blood pressure increases the risk of developing Alzheimer disease (AD).

Objective  To examine the association between incident AD and blood pressure measured up to 13 years before diagnosis.

Design  Longitudinal cohort study conducted from 1982 to 1988, with blood pressure measured every 3 years in home interviews, and in 1973 for a portion (60%) of the sample.

Setting  Community of East Boston, Mass.

Participants  Six hundred thirty-four subjects 65 years or older and without AD were selected as a stratified random sample of participants of the East Boston Established Populations for Epidemiologic Studies of the Elderly.

Main Outcome Measure  Alzheimer disease was diagnosed by a neurologist using a structured clinical evaluation.

Results  High blood pressure was not associated with an increased risk of AD in logistic regression models adjusted for age, sex, and level of education. There was no association with systolic pressure measured 13 years before diagnosis (odds ratio = 1.03/10 mm Hg; 95% confidence interval, 0.80-1.32) and an inverse association with systolic pressure measured 4 years before diagnosis (odds ratio = 0.82/10 mm Hg; 95% confidence interval, 0.72-0.95). Associations for diastolic pressure were in the same direction as those for systolic pressure except with wider confidence intervals. The odds ratios were not materially different with further adjustment for cardiovascular risk factors and diseases.

Conclusion  In this large community study, high blood pressure was not associated with an increased risk of AD.

From the Rush Institute for Healthy Aging (Drs Morris, Hebert, Bennett, and Evans) and Rush Alzheimer's Disease Center (Drs Bennett and Evans), and the Departments of Internal Medicine (Drs Morris, Hebert, and Evans), Preventive Medicine (Dr Morris), and Neurological Sciences (Drs Bennett and Evans), Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill; the Health Care and Aging Studies Branch, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Scherr); and the Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Mass (Dr Glynn).

Corresponding author and reprints: Martha Clare Morris, ScD, Rush Institute for Healthy Aging, Rush-Presbyterian-St Luke's Medical Center, 1645 W Jackson, Chicago, IL 60612 (e-mail: mmorris{at}rush.edu).

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