{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T17:25:25Z","timestamp":1777397125525,"version":"3.51.4"},"reference-count":54,"publisher":"SAGE Publications","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2024,4,16]]},"abstract":"<jats:p>Background: While mid-life hypertension represents a risk factor for the development of Alzheimer\u2019s disease (AD), the risk after the age of 65 is less certain. Establishing relationships between late life hypertension and the pathological changes of AD could be crucial in understanding the relevance of blood pressure as a risk factor for this disorder. Objective: We investigated associations between self-reported late-life hypertension, cognitive status and AD pathology at death. The impact of antihypertensive medication was also examined. Methods: Using the Cornell Medical Index questionnaire, we ascertained whether participants had ever reported hypertension. We also noted use of antihypertensive medication. The donated brains of 108 individuals were assessed for AD pathology using consensus guidelines. Statistical analysis aimed to elucidate relationships between hypertension and AD pathology. Results: We found no associations between self-reported hypertension and cognitive impairment at death. However, those with hypertension were significantly more likely to exhibit lower levels of AD pathology as measured by Thal phase, Braak stage, CERAD score, and NIA-AA criteria\u2014even after controlling for sex, level of education and presence of APOE \u025b4 allele(s). No significant associations could be found when examining use of antihypertensive medications. Conclusions: Our findings suggest that late-life hypertension is associated with less severe AD pathology. We postulate that AD pathology may be promoted by reduced cerebral blood flow.<\/jats:p>","DOI":"10.3233\/jad-231429","type":"journal-article","created":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T12:13:20Z","timestamp":1711455200000},"page":"1457-1466","source":"Crossref","is-referenced-by-count":2,"title":["Self-Reported Late-Life Hypertension Is Associated with a Healthy Cognitive Status and Reduced Alzheimer\u2019s Disease Pathology Burden1"],"prefix":"10.1177","volume":"98","author":[{"given":"Andrew C.","family":"Robinson","sequence":"first","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"},{"name":"Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tawfique","family":"Bin Rizwan","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Medical Sciences, School of Health Sciences, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne S.","family":"Davidson","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Minshull","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Tinkler","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antony","family":"Payton","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Health Sciences, Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.A.","family":"Mann","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Roncaroli","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Neuroscience, The University of Manchester, Salford Royal Hospital, Salford, UK"},{"name":"Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre (MAHSC), Manchester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-231429_ref1","doi-asserted-by":"crossref","first-page":"b75","DOI":"10.1136\/bmj.b75","article-title":"Dementia","volume":"338","author":"Burns","year":"2009","journal-title":"BMJ"},{"key":"10.3233\/JAD-231429_ref2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.2165\/00002512-199915050-00004","article-title":"Worldwide prevalence and incidence of dementia","volume":"15","author":"Fratiglioni","year":"1999","journal-title":"Drugs Aging"},{"key":"10.3233\/JAD-231429_ref3","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13195-015-0104-7","article-title":"Clinical and imaging features of mixed Alzheimer and vascular pathologies","volume":"7","author":"Chui","year":"2015","journal-title":"Alzheimers Res Ther"},{"key":"10.3233\/JAD-231429_ref4","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1161\/HYPERTENSIONAHA.114.03040","article-title":"Hypertension and dementia","volume":"64","author":"Iadecola","year":"2014","journal-title":"Hypertension"},{"key":"10.3233\/JAD-231429_ref5","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1038\/ajh.2009.212","article-title":"Hypertension and dementia","volume":"23","author":"Nagai","year":"2010","journal-title":"Am J Hypertens"},{"key":"10.3233\/JAD-231429_ref6","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1001\/jama.2019.10575","article-title":"Association of midlife to late-life blood pressure patterns with incident dementia","volume":"322","author":"Walker","year":"2019","journal-title":"JAMA"},{"key":"10.3233\/JAD-231429_ref7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1749-6632.2002.tb04796.x","article-title":"Hypertension and related factors in the etiology of Alzheimer\u2019s disease","volume":"977","author":"Skoog","year":"2002","journal-title":"Ann N Y Acad Sci"},{"key":"10.3233\/JAD-231429_ref8","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1001\/jamainternmed.2021.7009","article-title":"Association of systolic blood pressure with dementia risk and the role of age, u-shaped associations, and mortality","volume":"182","author":"van Dalen","year":"2022","journal-title":"JAMA Intern Med"},{"key":"10.3233\/JAD-231429_ref9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.arr.2008.11.001","article-title":"Blood pressure and the risk for dementia: a double edged sword","volume":"8","author":"Kennelly","year":"2009","journal-title":"Ageing Res Rev"},{"key":"10.3233\/JAD-231429_ref10","doi-asserted-by":"crossref","first-page":"107286","DOI":"10.1155\/2009\/107286","article-title":"Role of hypertension in aggravating Abeta neuropathology of AD type and tau-mediated motor impairment","volume":"2009","author":"D\u00edaz-Ruiz","year":"2009","journal-title":"Cardiovasc Psychiatry Neurol"},{"key":"10.3233\/JAD-231429_ref11","doi-asserted-by":"crossref","first-page":"2308","DOI":"10.1002\/alz.12707","article-title":"Hypertension and Alzheimer\u2019s disease pathology at autopsy: A systematic review","volume":"18","author":"Abdulrahman","year":"2022","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-231429_ref12","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/0022-510X(95)00105-B","article-title":"Increased incidence of neurofibrillary tangles (NFT) in non-demented individuals with hypertension","volume":"131","author":"Sparks","year":"1995","journal-title":"J Neurol Sci"},{"key":"10.3233\/JAD-231429_ref13","doi-asserted-by":"crossref","first-page":"fcaa114","DOI":"10.1093\/braincomms\/fcaa114","article-title":"Hypertension and Alzheimer\u2019s disease: indirect effects through circle of Willis atherosclerosis","volume":"2","author":"Eglit","year":"2020","journal-title":"Brain Commun"},{"key":"10.3233\/JAD-231429_ref14","first-page":"57","article-title":"Midlife blood pressure and neuritic plaques, neurofibrillary tangles, and brain weight at death: the HAAS. Honolulu-Asia aging Study","volume":"21","author":"Petrovitch","year":"2000","journal-title":"Neurobiol Aging"},{"key":"10.3233\/JAD-231429_ref15","doi-asserted-by":"crossref","first-page":"e517","DOI":"10.1212\/WNL.0000000000005951","article-title":"Late-life blood pressure association with cerebrovascular and Alzheimer disease pathology","volume":"91","author":"Arvanitakis","year":"2018","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref16","doi-asserted-by":"crossref","first-page":"1720","DOI":"10.1212\/01.wnl.0000345881.82856.d5","article-title":"Less Alzheimer disease neuropathology in medicated hypertensive than nonhypertensive persons","volume":"72","author":"Hoffman","year":"2009","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref17","doi-asserted-by":"crossref","first-page":"e12060","DOI":"10.1002\/trc2.12060","article-title":"Antihypertensive medications ameliorate Alzheimer\u2019s disease pathology by slowing its propagation","volume":"6","author":"Affleck","year":"2020","journal-title":"Alzheimers Dement (NY)"},{"key":"10.3233\/JAD-231429_ref18","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3233\/JAD-190011","article-title":"Neurofibrillary tangles and conversion to mild cognitive impairment with certain antihypertensives","volume":"70","author":"Wharton","year":"2019","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-231429_ref19","doi-asserted-by":"crossref","first-page":"e12922","DOI":"10.1111\/nan.12922","article-title":"Past antihypertensive medication use is associated with lower levels of small vessel disease and lower A\u03b2 plaque stage in the brains of older individuals","volume":"49","author":"Affleck","year":"2023","journal-title":"Neuropathol Appl Neurobiol"},{"key":"10.3233\/JAD-231429_ref20","doi-asserted-by":"crossref","first-page":"595","DOI":"10.3233\/JAD-2012-111697","article-title":"Antemortem pulse pressure elevation predicts cerebrovascular disease in autopsy-confirmed Alzheimer\u2019s disease","volume":"30","author":"Nation","year":"2012","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-231429_ref21","doi-asserted-by":"crossref","first-page":"1975","DOI":"10.1111\/j.1532-5415.2009.02493.x","article-title":"Blood pressure and brain injury in older adults: findings from a community-based autopsy study","volume":"57","author":"Wang","year":"2009","journal-title":"J Am Geriatr Soc"},{"key":"10.3233\/JAD-231429_ref22","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.3233\/JAD-160425","article-title":"Vascular contributions in Alzheimer\u2019s disease-related neuropathological changes: first autopsy evidence from a South Asian aging population","volume":"54","author":"Wijesinghe","year":"2016","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-231429_ref23","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1111\/joim.12736","article-title":"CAIDE Dementia Risk Score, Alzheimer and cerebrovascular pathology: a population-based autopsy study","volume":"283","author":"Hooshmand","year":"2018","journal-title":"J Intern Med"},{"key":"10.3233\/JAD-231429_ref24","doi-asserted-by":"crossref","first-page":"687","DOI":"10.2174\/156720512801322654","article-title":"The neuropathology of vascular disease in the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS)","volume":"9","author":"Richardson","year":"2012","journal-title":"Curr Alzheimer Res"},{"key":"10.3233\/JAD-231429_ref25","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1093\/jnen\/nlw072","article-title":"Late-life vascular risk factors and Alzheimer disease neuropathology in individuals with normal cognition","volume":"75","author":"Besser","year":"2016","journal-title":"J Neuropathol Exp Neurol"},{"key":"10.3233\/JAD-231429_ref26","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1080\/13825580490511116","article-title":"The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age, 1983 through 2003","volume":"11","author":"Rabbitt","year":"2004","journal-title":"Aging Neuropsychol Cogn"},{"key":"10.3233\/JAD-231429_ref27","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3233\/JAD-180171","article-title":"Pathological correlates of cognitive impairment in The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age","volume":"64","author":"Robinson","year":"2018","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-231429_ref28","doi-asserted-by":"crossref","first-page":"619","DOI":"10.3233\/JAD-190580","article-title":"A comparative study of pathological outcomes in The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age and Brains for Dementia Research Cohorts","volume":"73","author":"Robinson","year":"2020","journal-title":"J Alzheimers Dis"},{"key":"10.3233\/JAD-231429_ref29","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.archger.2003.10.005","article-title":"Concordance of Cornell medical index self-reports to structured clinical assessment for the identification of physical health status","volume":"38","author":"Pendleton","year":"2004","journal-title":"Arch Gerontol Geriatr"},{"key":"10.3233\/JAD-231429_ref30","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1212\/WNL.45.8.1446","article-title":"Intelligence and education as predictors of cognitive state in late life: a 50 year follow-up","volume":"45","author":"Plassman","year":"1995","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00401-011-0910-3","article-title":"National Institute on Aging-Alzheimer\u2019s Association guidelines for the neuropathologic assessment of Alzheimer\u2019s disease: a practical approach","volume":"123","author":"Montine","year":"2012","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-231429_ref32","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1212\/WNL.47.5.1113","article-title":"Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop","volume":"47","author":"McKeith","year":"1996","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref33","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1212\/01.wnl.0000187889.17253.b1","article-title":"Diagnosis and management of dementia with Lewy bodies: third report of the DLB Consortium","volume":"65","author":"McKeith","year":"2005","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref34","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium","volume":"89","author":"McKeith","year":"2017","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref35","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s00401-008-0460-5","article-title":"Nomenclature for neuropathologic subtypes of frontotemporal lobar degeneration: consensus recommendations","volume":"117","author":"Mackenzie","year":"2009","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-231429_ref36","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00401-011-0845-8","article-title":"A harmonized classification system for FTLD-TDP pathology","volume":"122","author":"Mackenzie","year":"2011","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-231429_ref37","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1093\/jnen\/61.11.935","article-title":"Office of Rare Diseases neuropathologic criteria for corticobasal degeneration","volume":"61","author":"Dickson","year":"2002","journal-title":"J Neuropathol Exp Neurol"},{"key":"10.3233\/JAD-231429_ref38","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1212\/WNL.44.11.2015","article-title":"Preliminary NINDS neuropathologic criteria for Steele-Richardson-Olszewski syndrome (progressive supranuclear palsy)","volume":"44","author":"Hauw","year":"1994","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref39","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1111\/j.1365-2990.2007.00907.x","article-title":"Proposed neuropathological criteria for the post mortem diagnosis of multiple system atrophy","volume":"33","author":"Trojanowski","year":"2007","journal-title":"Neuropathol Appl Neurobiol"},{"key":"10.3233\/JAD-231429_ref40","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1007\/s007020050096","article-title":"Argyrophilic grain disease: frequency of occurrence in different age categories and neuropathological diagnostic criteria","volume":"105","author":"Braak","year":"1998","journal-title":"J Neural Transm (Vienna)"},{"key":"10.3233\/JAD-231429_ref41","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1007\/s00401-014-1349-0","article-title":"Primary age-related tauopathy (PART): a common pathology associated with human aging","volume":"128","author":"Crary","year":"2014","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-231429_ref42","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00401-015-1509-x","article-title":"Aging-related tau astrogliopathy (ARTAG): harmonized evaluation strategy","volume":"131","author":"Kovacs","year":"2016","journal-title":"Acta Neuropathol"},{"key":"10.3233\/JAD-231429_ref43","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1093\/brain\/awz099","article-title":"Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report","volume":"142","author":"Nelson","year":"2019","journal-title":"Brain"},{"key":"10.3233\/JAD-231429_ref44","doi-asserted-by":"crossref","first-page":"2957","DOI":"10.1093\/brain\/aww214","article-title":"Vascular cognitive impairment neuropathology guidelines (VCING): the contribution of cerebrovascular pathology to cognitive impairment","volume":"139","author":"Skrobot","year":"2016","journal-title":"Brain"},{"key":"10.3233\/JAD-231429_ref45","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/S0024-3205(02)02367-6","article-title":"Relationship between blood pressure and Alzheimer\u2019s disease in Linxian County, China","volume":"72","author":"Wu","year":"2003","journal-title":"Life Sci"},{"key":"10.3233\/JAD-231429_ref46","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1161\/CIRCRESAHA.116.309493","article-title":"Is High Blood Pressure Self-Protection for the Brain?","volume":"119","author":"Warnert","year":"2016","journal-title":"Circ Res"},{"key":"10.3233\/JAD-231429_ref47","doi-asserted-by":"crossref","first-page":"fcad112","DOI":"10.1093\/braincomms\/fcad112","article-title":"Elevated late-life blood pressure may maintain brain oxygenation and slow amyloid-\u03b2 accumulation at the expense of cerebral vascular damage","volume":"5","author":"Tayler","year":"2023","journal-title":"Brain Commun"},{"key":"10.3233\/JAD-231429_ref48","doi-asserted-by":"crossref","first-page":"2053","DOI":"10.1161\/STROKEAHA.118.021578","article-title":"Long-term premorbid blood pressure and cerebral small vessel disease burden on imaging in transient ischemic attack and ischemic stroke","volume":"49","author":"Lau","year":"2018","journal-title":"Stroke"},{"key":"10.3233\/JAD-231429_ref49","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/S1474-4422(14)70031-6","article-title":"Acute post-stroke blood pressure relative to premorbid levels in intracerebral haemorrhage versus major ischaemic stroke: a population-based study","volume":"13","author":"Fischer","year":"2014","journal-title":"Lancet Neurol"},{"key":"10.3233\/JAD-231429_ref50","doi-asserted-by":"crossref","first-page":"e1732","DOI":"10.1212\/WNL.0000000000005526","article-title":"Time course of blood pressure control prior to lacunar TIA and stroke: Population-based study","volume":"90","author":"Li","year":"2018","journal-title":"Neurology"},{"key":"10.3233\/JAD-231429_ref51","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1161\/STROKEAHA.121.035850","article-title":"New insights into cerebrovascular pathophysiology and hypertension","volume":"53","author":"Webb","year":"2022","journal-title":"Stroke"},{"key":"10.3233\/JAD-231429_ref52","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1007\/s12640-018-9895-1","article-title":"Clearance of amyloid beta and tau in Alzheimer\u2019s disease: from mechanisms to therapy","volume":"34","author":"Xin","year":"2018","journal-title":"Neurotox Res"},{"key":"10.3233\/JAD-231429_ref53","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1038\/nrneurol.2015.119","article-title":"Clearance systems in the brain-implications for Alzheimer disease","volume":"11","author":"Tarasoff-Conway","year":"2015","journal-title":"Nat Rev Neurol"},{"key":"10.3233\/JAD-231429_ref54","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1126\/science.1566067","article-title":"Alzheimer\u2019s disease: the amyloid cascade hypothesis","volume":"256","author":"Hardy","year":"1992","journal-title":"Science"}],"container-title":["Journal of Alzheimer's Disease"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/JAD-231429","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T10:09:48Z","timestamp":1777370988000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/JAD-231429"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":54,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3233\/jad-231429","relation":{},"ISSN":["1387-2877","1875-8908"],"issn-type":[{"value":"1387-2877","type":"print"},{"value":"1875-8908","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,16]]}}}