Nighttime BP Increases Could Be Linked to Alzheimer Disease Risk

Reverse dipping of systolic blood pressure (BP) may be a risk factor for dementia in older men, according to the results of a recent study.

The researchers conducted a longitudinal study to examine the association of a lower day-to-night systolic BP dip on older men’s brain health, specifically looking at both reduced dipping, classified as a nighttime/daytime ratio of systolic BP >0.9 and ≤1, and reverse dipping, classified as a nighttime/daytime ratio of systolic BP >1. To determine the dipping status, all participants underwent 24-hour ambulatory BP monitoring.

Included in this study were 997 Swedish men with a mean age of 71 years and 611 men with a mean age of 77.6 years. Antihypertensive medication was present in 35% and 41% of the participants, respectfully.

In the 24-year observational period, there were 286 cases of dementia incidence. A dementia diagnosis was confirmed following a review of the patient’s medical history as well as confirmation from at least 2, independent, experienced geriatricians.

The results of the study indicated that patients who had reverse systolic BP dipping had a higher risk of a dementia and Alzheimer disease diagnoses. This association was not present for vascular dementia. In addition, an increased risk of a dementia diagnosis was not related to reduced dipping of nocturnal systolic BP.

“Our findings suggest that reverse systolic BP dipping may represent an independent risk factor for dementia and Alzheimer disease in older men,” the study authors concluded. “Future studies should decipher whether therapies lowering nocturnal systolic BP below daytime levels, such as bedtime dosing of antihypertensive medication, can meaningfully curb the development of dementia.”

—Leigh Precopio

Reference:

Tan X, Sundström J, Lind L, Franzon K, Kilander L, Benedict C. Reverse dipping of systolic blood pressure is associated with increased dementia risk in older men. Hypertension. Published online February 8, 2021.  https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16711