Are Alzheimer's disease, hypertension, and cerebrocapillary damage related?

Alzheimer's disease (AD) patients are often subject to vascular dysfunction besides their specific CNS pathology, which warrants further examination o f the interaction between vascular factors and the development of dementia. The association of decreased cerebral blood flow (CBF) or hypertension wit h AD has been a target of growing interest. Parallel with physiological cha nges, the cerebral capillaries in AD are also prone to degenerative process es. The microvascular abnormalities that are the result of such degeneratio n may be the morphological correlates of the vascular pathophysiology point ing to a compromised nutrient transport through the capillaries. Animal mod els have been developed to study the consequences of hypertension and reduc ed CBF. Spontaneously hypertensive rats are widely used in hypertension res earch whereas ligation of the carotid arteries has become a method to produ ce cerebral hypoperfusion. Based on these models, we propose a relationship between hypertension, cerebral hypoperfusion, cerebral capillary malformat ion and cognitive decline as it occurs in AD. We suggest that the above con ditions are functionally related and can contribute to the progression of A D. (C) 2000 Elsevier Science Inc. All rights reserved.