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Combined effects of APOE genotype, blood pressure, and antihypertensive drug use on incident AD.
Neurology 2003; 61(5):655-60Neur

Abstract

OBJECTIVE

To study the hypotheses that APOE-epsilon4 allele may interact with blood pressure to affect Alzheimer's disease (AD) occurrence and that antihypertensive therapy could modify such an effect.

METHODS

A dementia-free cohort of 966 community-dwelling persons aged 75 years and older in Stockholm, Sweden was followed to detect patients with AD using the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) diagnostic criteria. Data were analyzed using Cox proportional hazards models with adjustment for several potential confounders.

RESULTS

During a 6-year follow-up period, AD was diagnosed in 204 persons. APOE-epsilon4 allele, high systolic pressure (> or = 140 mm Hg), and low diastolic pressure (<70 mm Hg) were associated with an increased risk of AD. APOE-epsilon4 allele combined with low diastolic pressure greatly increased the risk of AD independent of antihypertensive drug use. Antihypertensive therapy significantly reduced the risk of AD regardless of APOE-epsilon4 status and counteracted the combined risk effect of the epsilon4 allele with high systolic pressure on the disease.

CONCLUSIONS

Elderly people with genetic susceptibility for Alzheimer's disease may experience a further increased disease risk if they have either high systolic pressure or low diastolic pressure. Antihypertensive therapy decreases the risk of Alzheimer's disease exerted by the APOE-epsilon4 allele.

Authors+Show Affiliations

Aging Research Center, Division of Geriatric Epidemiology and Medicine, Department of Neurotec, Karolinska Institutet and the Stockholm Gerontology Research Center, Stockholm, Sweden. chengxuan.qiu@neurotec.ki.seNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12963757

Citation

Qiu, Chengxuan, et al. "Combined Effects of APOE Genotype, Blood Pressure, and Antihypertensive Drug Use On Incident AD." Neurology, vol. 61, no. 5, 2003, pp. 655-60.
Qiu C, Winblad B, Fastbom J, et al. Combined effects of APOE genotype, blood pressure, and antihypertensive drug use on incident AD. Neurology. 2003;61(5):655-60.
Qiu, C., Winblad, B., Fastbom, J., & Fratiglioni, L. (2003). Combined effects of APOE genotype, blood pressure, and antihypertensive drug use on incident AD. Neurology, 61(5), pp. 655-60.
Qiu C, et al. Combined Effects of APOE Genotype, Blood Pressure, and Antihypertensive Drug Use On Incident AD. Neurology. 2003 Sep 9;61(5):655-60. PubMed PMID: 12963757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined effects of APOE genotype, blood pressure, and antihypertensive drug use on incident AD. AU - Qiu,Chengxuan, AU - Winblad,Bengt, AU - Fastbom,Johan, AU - Fratiglioni,Laura, PY - 2003/9/10/pubmed PY - 2004/1/30/medline PY - 2003/9/10/entrez SP - 655 EP - 60 JF - Neurology JO - Neurology VL - 61 IS - 5 N2 - OBJECTIVE: To study the hypotheses that APOE-epsilon4 allele may interact with blood pressure to affect Alzheimer's disease (AD) occurrence and that antihypertensive therapy could modify such an effect. METHODS: A dementia-free cohort of 966 community-dwelling persons aged 75 years and older in Stockholm, Sweden was followed to detect patients with AD using the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) diagnostic criteria. Data were analyzed using Cox proportional hazards models with adjustment for several potential confounders. RESULTS: During a 6-year follow-up period, AD was diagnosed in 204 persons. APOE-epsilon4 allele, high systolic pressure (> or = 140 mm Hg), and low diastolic pressure (<70 mm Hg) were associated with an increased risk of AD. APOE-epsilon4 allele combined with low diastolic pressure greatly increased the risk of AD independent of antihypertensive drug use. Antihypertensive therapy significantly reduced the risk of AD regardless of APOE-epsilon4 status and counteracted the combined risk effect of the epsilon4 allele with high systolic pressure on the disease. CONCLUSIONS: Elderly people with genetic susceptibility for Alzheimer's disease may experience a further increased disease risk if they have either high systolic pressure or low diastolic pressure. Antihypertensive therapy decreases the risk of Alzheimer's disease exerted by the APOE-epsilon4 allele. SN - 1526-632X UR - https://www.unboundmedicine.com/medline/citation/12963757/Combined_effects_of_APOE_genotype_blood_pressure_and_antihypertensive_drug_use_on_incident_AD_ L2 - http://www.neurology.org/cgi/pmidlookup?view=long&amp;pmid=12963757 DB - PRIME DP - Unbound Medicine ER -