Associations of blood pressure with functional and cognitive changes in patients with alzheimer's disease

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dc.contributor.authorde Oliveira, Fabricio Ferreira [UNIFESP]
dc.contributor.authorChen, Elizabeth Suchi [UNIFESP]
dc.contributor.authorSmith, Marilia Cardoso [UNIFESP]
dc.contributor.authorFerreira Bertolucci, Paulo Henrique [UNIFESP]
dc.date.accessioned2019-01-21T10:29:51Z
dc.date.available2019-01-21T10:29:51Z
dc.date.issued2016
dc.description.abstractBackground: Midlife hypertension followed by late life hypotension resulting from neurodegeneration increases amyloidogenesis and tauopathy. Methods: Consecutive outpatients with late-onset Alzheimer's disease (AD) at various stages and their respective caregivers were assessed for score variations in 1 year of tests assessing caregiver burden, functionality and cognition according to blood pressure (BP) variations and APOE haplotypes, while also taking into account differential effects of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, diuretics, or no antihypertensive medication on score changes. The diagnosis and treatment of arterial hypertension followed the JNC 7 report. Results: Variations in systolic BP (-11.76 +/- 17.1 mm Hg), diastolic BP (-4.92 +/- 10.3 mm Hg) and pulse pressure (-6.84 +/- 12.6 mm Hg) were significant after 1 year (n = 191;. < 0.01). For APOE4+ carriers, rises in systolic or diastolic BP improved Clinical Dementia Rating Scale Sum of Boxes scores (rho < 0.04), with marginally significant improvements in MiniMental State Examination scores resulting from risen systolic (rho = 0.069) or diastolic BP (. = 0.079), and in basic independence only regarding risen diastolic BP (rho = 0.055). APOE4-carriers resisted any functional or cognitive effects of BP variations. No differences were found regarding any antihypertensive class for variations in BP or any test scores, regardless of APOE haplotypes. Conclusions: Targeting mild BP elevations brings better functional and cognitive results for APOE4+ carriers with AD. (C) 2016 S. Karger AG, Baselen
dc.description.affiliationDepartments of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
dc.description.affiliationMorphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
dc.description.affiliationUnifespDepartments of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), Rua Botucatu 740,Vila Clementino, BR-04023900 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespMorphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipCoordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) [1067/10]
dc.description.sponsorshipState of Sao Paulo Research Foundation (FAPESP) [2015/10109-5]
dc.description.sponsorshipIDCAPES: 1067/10
dc.description.sponsorshipIDFAPESP: 2015/10109-5
dc.format.extent314-323
dc.identifierhttps://doi.org/10.1159/000447585
dc.identifier.citationDementia And Geriatric Cognitive Disorders. Basel, v. 41, n. 43256, p. 314-323, 2016.
dc.identifier.doi10.1159/000447585
dc.identifier.issn1420-8008
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/49438
dc.identifier.wosWOS:000381877400008
dc.language.isoeng
dc.publisherConsel Brasil Oftalmologia
dc.relation.ispartofDementia And Geriatric Cognitive Disorders
dc.rightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectAlzheimer's Diseaseen
dc.subjectCognitive Disordersen
dc.subjectDementiaen
dc.subjectNeurodegenerative Diseasesen
dc.subjectHypertensionen
dc.subjectActivities Of Daily Livingen
dc.subjectNeuropsychiatryen
dc.subjectApoeVascular Risk-Factorsen
dc.subjectDementia Rating-Scaleen
dc.subjectSao-Pauloen
dc.subjectCardiovascular-Diseaseen
dc.subjectPulse Pressureen
dc.subjectFollow-Upen
dc.subjectProgressionen
dc.subjectPopulationen
dc.subjectDeclineen
dc.subjectVariabilityen
dc.titleAssociations of blood pressure with functional and cognitive changes in patients with alzheimer's diseaseen
dc.typeinfo:eu-repo/semantics/article
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