{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:54:19Z","timestamp":1790171659627,"version":"4.1.0"},"reference-count":68,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Hypertension"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>\n            Blood pressure variability (BPV) has been shown to have predictive value over blood pressure (BP) levels alone in stroke patients. We assessed whether BPV predicts cognitive and functional decline in Alzheimer disease, using data from a randomized trial (NILVAD [A European Multicentre Double-blind Placebo-controlled Phase III Trial of Nilvadipine in Mild to Moderate Alzheimer\u2019s Disease]). Patients with mild-to-moderate Alzheimer disease were included if they had \u22653 office BP measurements available to determine visit-to-visit BPV. Day-to-day BPV was assessed using home BP measurements in a subsample. The variation independent of mean was used to calculate BPV. Outcomes were change in Alzheimer\u2019s Disease Assessment Scale\u2013cognitive subscale-12 and Disability Assessment for Dementia after 1 and 1.5 years. A total of 460 patients aged 72.1 (SD=8.1) years, with mean BP of 134.0\/75.1 (10.9\/6.3) mm\u2009Hg were included. After 1 year, patients in the highest quartile of BPV had deteriorated more on Alzheimer\u2019s Disease Assessment Scale\u2013cognitive subscale compared with patients in the lowest quartile (systolic: \u03b2, 2.24 [95% CI, 0.11\u20134.38],\n            <jats:italic>P<\/jats:italic>\n            =0.040; diastolic: \u03b2, 2.54 [95% CI, 0.33\u20134.75]\n            <jats:italic>P<\/jats:italic>\n            =0.024). This association was still present after 1.5 years (systolic: \u03b2, 2.86 [95% CI, 0.35\u20135.36],\n            <jats:italic>P<\/jats:italic>\n            =0.026; diastolic: \u03b2, 3.30 [95% CI, 0.67\u20135.93],\n            <jats:italic>P<\/jats:italic>\n            =0.014). There was no effect of visit-to-visit BPV on Disability Assessment for Dementia. Day-to-day BPV was available for 46 patients. Significant associations were observed between day-to-day BPV and deterioration on Alzheimer\u2019s Disease Assessment Scale\u2013cognitive subscale (systolic:\n            <jats:italic>P<\/jats:italic>\n            =0.036) and Disability Assessment for Dementia (systolic:\n            <jats:italic>P<\/jats:italic>\n            =0.020; diastolic:\n            <jats:italic>P<\/jats:italic>\n            =0.007) after 1 year, but not after 1.5 years. All associations were adjusted for potential confounders, including intervention group. In conclusion, this post hoc analysis indicates that higher visit-to-visit and day-to-day BPV might be associated with progression of Alzheimer disease. Targeting BPV may be a future target to slow decline in patients with Alzheimer disease.\n          <\/jats:p>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT02017340.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/hypertensionaha.119.13664","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T09:00:55Z","timestamp":1569229255000},"page":"1172-1180","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Blood Pressure Variability and Progression of Clinical Alzheimer Disease"],"prefix":"10.1161","volume":"74","author":[{"given":"Rianne A.A.","family":"de Heus","sequence":"first","affiliation":[{"name":"From the Department of Geriatric Medicine, Radboud umc University Medical Center, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., M.G.M.O.R., J.A.H.R.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel G.M.","family":"Olde Rikkert","sequence":"additional","affiliation":[{"name":"From the Department of Geriatric Medicine, Radboud umc University Medical Center, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., M.G.M.O.R., J.A.H.R.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip J.","family":"Tully","sequence":"additional","affiliation":[{"name":"School of Medicine, The University of Adelaide, Australia (P.J.T.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian A.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Mercer\u2019s Institute for Research on Ageing, St. James\u2019s Hospital, Dublin, Ireland (B.A.L.)"},{"name":"Department of Medical Gerontology, Trinity College Institute of Neuroscience, Dublin, Ireland (B.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgen A.H.R.","family":"Claassen","sequence":"additional","affiliation":[{"name":"From the Department of Geriatric Medicine, Radboud umc University Medical Center, Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (R.A.A.d.H., M.G.M.O.R., J.A.H.R.C.)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the NILVAD Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms11934"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI97509"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrn.2017.48"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000053"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.322.7300.1447"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31363-6"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy288"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.8164"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.66.3.343"},{"key":"e_1_3_4_11_2","first-page":"208","article-title":"Hypertension and the rate of cognitive decline in patients with dementia of the Alzheimer type.","volume":"18","author":"Bellew KM","year":"2004","unstructured":"Bellew, KM, Pigeon, JG, Stang, PE, Fleischman, W, Gardner, RM, Baker, WW. 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