Dr. Sandra Black Centre for Brain Resilience and Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada.
Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.
Alzheimers Dement. 2024 Apr;20(4):2766-2778. doi: 10.1002/alz.13717. Epub 2024 Feb 29.
Hypertension and diabetes are common cardiovascular risk factors that increase Alzheimer's disease (AD) risk. However, it is unclear whether AD risk differs in hypertensive individuals with and without diabetes.
Cognitively normal individuals (N = 11,074) from the National Alzheimer's Coordinating Center (NACC) were categorized as having (1) hypertension with diabetes (HTN+/DM+), (2) hypertension without diabetes (HTN+/DM-), or (3) neither (HTN-/DM-). AD risk in HTN+/DM+ and HTN+/DM- was compared to HTN-/DM-. This risk was then investigated in those with AD neuropathology (ADNP), cerebral amyloid angiopathy (CAA), cerebrovascular neuropathology (CVNP), arteriolosclerosis, and atherosclerosis. Finally, AD risk in HTN-/DM+ was compared to HTN-/DM-.
Seven percent (N = 830) of individuals developed AD. HTN+/DM+ (hazard ratio [HR] = 1.31 [1.19-1.44]) and HTN+/DM- (HR = 1.24 [1.17-1.32]) increased AD risk compared to HTN-/DM-. AD risk was greater in HTN+/DM+ with ADNP (HR = 2.10 [1.16-3.79]) and CAA (HR = 1.52 [1.09-2.12]), and in HTN+/DM- with CVNP (HR = 1.54 [1.17-2.03]). HTN-/DM+ also increased AD risk (HR = 1.88 [1.30-2.72]) compared to HTN-/DM-.
HTN+/DM+ and HTN+/DM- increased AD risk compared to HTN-/DM-, but pathological differences between groups suggest targeted therapies may be warranted based on cardiovascular risk profiles.
AD risk was studied in hypertensive (HTN+) individuals with/without diabetes (DM+/-). HTN+/DM+ and HTN+/DM- both had an increased risk of AD compared to HTN-/DM-. Post mortem analysis identified neuropathological differences between HTN+/DM+ and HTN+/DM-. In HTN+/DM+, AD risk was greater in those with AD neuropathology and CAA. In HTN+/DM-, AD risk was greater in those with cerebrovascular neuropathology.
高血压和糖尿病是常见的心血管危险因素，会增加阿尔茨海默病（AD）的风险。然而，患有高血压的个体中，有糖尿病和没有糖尿病的 AD 风险是否不同尚不清楚。
来自国家阿尔茨海默病协调中心（NACC）的认知正常个体（N=11074）分为以下三类：（1）有高血压伴糖尿病（HTN+/DM+），（2）有高血压无糖尿病（HTN+/DM-），或（3）既无高血压也无糖尿病（HTN-/DM-）。将 HTN+/DM+和 HTN+/DM-的 AD 风险与 HTN-/DM-进行比较。然后在有 AD 神经病理学（ADNP）、脑淀粉样血管病（CAA）、脑血管神经病理学（CVNP）、小动脉硬化和动脉粥样硬化的个体中研究这种风险。最后，将 HTN-/DM+的 AD 风险与 HTN-/DM-进行比较。
7%的个体（N=830）发生了 AD。与 HTN-/DM-相比，HTN+/DM+（风险比 [HR]1.31[1.19-1.44]）和 HTN+/DM-（HR 1.24[1.17-1.32]）增加了 AD 风险。HTN+/DM+伴有 ADNP（HR 2.10[1.16-3.79]）和 CAA（HR 1.52[1.09-2.12]）以及 HTN+/DM-伴有 CVNP（HR 1.54[1.17-2.03]）的个体，AD 风险更高。HTN-/DM+与 HTN-/DM-相比，AD 风险也更高（HR 1.88[1.30-2.72]）。
与 HTN-/DM-相比，HTN+/DM+和 HTN+/DM-均增加了 AD 风险，但两组之间的病理差异表明，可能需要根据心血管风险状况进行靶向治疗。
研究了有/无糖尿病（DM+/-）的高血压（HTN+）个体的 AD 风险。与 HTN-/DM-相比，HTN+/DM+和 HTN+/DM-均增加了 AD 风险。死后分析确定了 HTN+/DM+和 HTN+/DM-之间的神经病理学差异。在 HTN+/DM+中，ADNP 和 CAA 患者的 AD 风险更高。在 HTN+/DM-中，CVNP 患者的 AD 风险更高。
