Midlife blood pressure and neuritic plaques, neurofibrillary tangles, and brain weight at death: the HAAS

Midlife hypertension is associated with later development of cognitive impa irment, vascular dementia (VsD), and possibly Alzheimer's disease (AD). Neu ropathic cerebrovascular lesions and brain atrophy have been associated wit h elevated blood pressure (BP), however, to our knowledge there have been n o prospective investigations of an association of blood pressure levels mea sured in midlife with the microscopic lesions of AD. The investigated the r elationship of BP level in midlife to development of neurofibrillary tangle s (NFT), neuritic plaques (WP), and low brain weight at autopsy among Japan ese-American men who were members of the Honolulu Heart Program/Honolulu-As ia aging Study (HHP/HAAS) cohort. The HHP/HAAS is a population-based, longi tudinal study of cognitive function and dementia with 36 years of follow-up . Neocortical and hippocampal NFT and NP were counted per mm(2) and fixed b rain weight was measured for 243 decedents. Elevated systolic BP, (greater than or equal to 160 mm Hg) in midlife was associated with low brain weight and greater numbers of NP in both neocortex and hippocampus. Diastolic BP elevation, (greater than or equal to 95 mm Hg) was associated with greater numbers of NFT in hippocampus. Results indicate that in addition to the acc epted association of high BP with neuropathic cerebrovascular lesions, ther e is a direct relationship with brain atrophy, NP and NFT. (C) 2000 Elsevie r Science Inc. All rights reserved.