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Blood Pressure Levels and Risks of Dementia: a Nationwide Study of 4.5 Million People

Authors
 Chan Joo Lee  ;  Ji-Yeon Lee  ;  Kyungdo Han  ;  Da Hye Kim  ;  Hanna Cho  ;  Kwang Joon Kim  ;  Eun Seok Kang  ;  Bong-Soo Cha  ;  Yong-Ho Lee  ;  Sungha Park 
Citation
 HYPERTENSION, Vol.79(1) : 218-229, 2022-01 
Journal Title
HYPERTENSION
ISSN
 0194-911X 
Issue Date
2022-01
MeSH
Aged ; Aged, 80 and over ; Alzheimer Disease / epidemiology ; Alzheimer Disease / physiopathology ; Antihypertensive Agents / therapeutic use ; Blood Pressure / physiology* ; Comorbidity ; Dementia / epidemiology* ; Dementia / physiopathology ; Dementia, Vascular / epidemiology ; Dementia, Vascular / physiopathology ; Female ; Humans ; Hypertension / drug therapy ; Hypertension / epidemiology* ; Hypertension / physiopathology ; Incidence ; Male ; Middle Aged ; Risk
Keywords
Alzheimer disease ; antihypertensive agents ; blood pressure ; dementia ; incidence
Abstract
There are inconsistent results on the impacts of controlling blood pressure (BP) on the risk of dementia. We investigated the association between BP and risk of dementia subtypes by antihypertensive treatment and comorbidities. Using the Korean National Health Insurance Service-Health Screening Database from 2009 to 2012, a total of 4 522 447 adults aged 60+ years without a history of dementia were analyzed and followed up for a mean of 5.4 years. Individuals were classified according to their baseline systolic BP (SBP) and diastolic BP; SBP 130 to <140 mm Hg and diastolic BP 80 to <90 mm Hg were used as reference groups. The risk of overall dementia and probable Alzheimer disease was significantly higher in the SBP≥160 and lower SBP groups. These U-shaped associations were consistent regardless of antihypertensive use or comorbidities. The risk of probable vascular dementia (VaD) was not higher among lower SBP groups and increased gradually as SBP increased. Although there was a linear association between SBP and the risk of probable VaD in individuals not taking antihypertensives or without comorbidities, there was a U-shaped association in individuals taking antihypertensives or with comorbidities. Patterns of association between diastolic BP and risk of probable Alzheimer disease or probable VaD were similar to those with SBP, except for the risk of probable VaD in individuals taking antihypertensives. In conclusion, risks of probable Alzheimer disease and probable VaD were different among lower BP groups. Although the risk of dementia appears higher in people with lower BP receiving antihypertensives, this finding may be affected by comorbidities.
Full Text
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.121.17283
DOI
10.1161/HYPERTENSIONAHA.121.17283
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Ji Yeon(이지연)
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Cho, Hanna(조한나) ORCID logo https://orcid.org/0000-0001-5936-1546
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187908
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