Faculty of Medicine, University of New South Wales.
Centre for Healthy Brain Aging, University of New South Wales, Sydney.
Curr Opin Psychiatry. 2021 Mar 1;34(2):142-148. doi: 10.1097/YCO.0000000000000684.
The relationship between hypertension and Alzheimer's disease (AD) is complex and varies across the lifespan. Studies have suggested that midlife hypertension is a risk factor for AD, although studies of late life hypertension have suggested that it either has no effect or a weak protective effect.
Animal models of induced and spontaneous hypertension have found that AD pathological change (β-amyloid plaques and tau tangles) occurs within weeks of a hypertensive insult. Human imaging and autopsy studies indicate that midlife and late life hypertension are associated with increased AD pathological change. Meta-analyses of longitudinal studies indicate that midlife rather than late life hypertension is a risk factor for AD. New areas of research have suggested that rather than mean blood pressure (BP), it is the negative BP trajectories or the variability of BP that contributes to AD. In a number of meta-analyses of antihypertensive medications and their effect on AD, there were weak associations between improved AD outcomes and treatment.
The combined analysis of animal, human clinical/pathological, epidemiological and drug trial data indicates that hypertension increases the risk of AD and treatment of hypertension may be an appropriate preventive measure.
高血压与阿尔茨海默病（AD）之间的关系很复杂，并且在整个生命周期中有所不同。研究表明，中年高血压是 AD 的一个危险因素，尽管对老年高血压的研究表明，它要么没有影响，要么具有较弱的保护作用。
诱导和自发性高血压动物模型发现，高血压损伤后数周内就会出现 AD 病理变化（β-淀粉样斑块和 tau 缠结）。人类影像学和尸检研究表明，中年和老年高血压与 AD 病理变化的增加有关。对纵向研究的荟萃分析表明，中年高血压而不是老年高血压是 AD 的一个危险因素。新的研究领域表明，导致 AD 的因素不是平均血压（BP），而是 BP 的负向轨迹或 BP 的可变性。在一些抗高血压药物及其对 AD 影响的荟萃分析中，改善 AD 结局与治疗之间存在微弱的关联。
动物、人类临床/病理、流行病学和药物试验数据的综合分析表明，高血压会增加 AD 的风险，治疗高血压可能是一种适当的预防措施。
