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We investigated the relationship of blood pressure (BP) with medial temporal lobe (MTL) dynamic network flexibility (a novel AD biomarker) and cognitive generalization in older African Americans. In a cross\u2010sectional study, 37 normotensive (systolic BP &lt;130\u2009mmHg, 82.5% F, 64.4\u2009\u00b1\u20094.9\u2009years; 14.3\u2009\u00b1\u20092.1\u2009years of education) versus 79 hypertensive (systolic BP \u2265130\u2009mmHg, 79.5% F, 66.8\u2009\u00b1\u20094.1\u2009years; 14.0\u2009\u00b1\u20090.2\u2009years of education) participants were enrolled. All participants completed a 10\u2010min resting\u2010state functional magnetic resonance imaging scan to assess MTL dynamic network flexibility and two generalization tasks to assess cognition. Anthropometrics and aerobic fitness (via 6\u2010min walk test) were also determined. There was no difference in BMI (29.7\u2009\u00b1\u20096.4 vs. 31.9\u2009\u00b1\u20096.3\u2009kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009=\u20090.083) or aerobic fitness (15.5\u2009\u00b1\u20092.6 vs. 15.1\u2009\u00b1\u20092.6\u2009mL\/kg\/min; <jats:italic>p<\/jats:italic>\u2009=\u20090.445) between normotensive and hypertensive groups. However, normotensive participants had higher MTL dynamic network flexibility compared to hypertensive participants (0.42\u2009\u00b1\u20090.23 vs. 0.32\u2009\u00b1\u20090.25\u2009mL, <jats:italic>p<\/jats:italic>\u2009=\u20090.040), and this was associated with higher mean arterial blood pressure (<jats:italic>r<\/jats:italic>\u2009=\u2009\u22120.21, <jats:italic>p<\/jats:italic>\u2009=\u20090.036). Therefore, hypertensive older African Americans demonstrated lower MTL dynamic network flexibility compared to their normotensive counterparts independent of BMI and aerobic fitness. Further studies are required to determine how blood pressure mediates AD risk in African Americans.<\/jats:p>","DOI":"10.14814\/phy2.16084","type":"journal-article","created":{"date-parts":[[2024,6,8]],"date-time":"2024-06-08T09:40:19Z","timestamp":1717839619000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypertension is associated with reduced resting\u2010state medial temporal lobe dynamic network flexibility in older African Americans"],"prefix":"10.14814","volume":"12","author":[{"given":"Joshua L.","family":"Gills","sequence":"first","affiliation":[{"name":"Department of Psychiatry New York University Grossman School of Medicine  New York New York USA"},{"name":"Department of Population Health New York University Grossman School of Medicine  New York New York USA"},{"name":"Center for Molecular and Behavioral Neuroscience Rutgers University\u2010Newark  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darian A.","family":"Napoleon","sequence":"additional","affiliation":[{"name":"Center for Molecular and Behavioral Neuroscience Rutgers University\u2010Newark  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miray","family":"Budak","sequence":"additional","affiliation":[{"name":"Center for Molecular and Behavioral Neuroscience Rutgers University\u2010Newark  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernadette A.","family":"Fausto","sequence":"additional","affiliation":[{"name":"Center for Molecular and Behavioral Neuroscience Rutgers University\u2010Newark  Newark New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A.","family":"Gluck","sequence":"additional","affiliation":[{"name":"Center for Molecular and Behavioral Neuroscience Rutgers University\u2010Newark  Newark New Jersey 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