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Cerebral autoregulation in patients with MCI and dementia due to Alzheimer's disease: Effects of blood pressure lowering on CBF
Author(s) -
Claassen Jurgen A.H.R.,
de Heus Rianne A.A.,
Rikkert Marcel G.M. Olde,
de Jong Daan LK,
Sanders Marit
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.041943
Subject(s) - dementia , autoregulation , medicine , cardiology , cerebral blood flow , blood pressure , cerebral perfusion pressure , cerebral autoregulation , calcium channel blocker , disease
Background Blood pressure (BP) lowering is a promising strategy to prevent dementia, including AD (SPRINT‐MIND). BP lowering should therefore be explored as a secondary prevention strategy in patients with early stages of AD (MCI due to AD and preclinical AD). However, if cerebral autoregulation is impaired in (older) patients with AD, BP lowering could cause cerebral hypoperfusion and lead to progression of disease Method we studied cerebral autoregulation at baseline in 40 patients with amnestic MCI and 50 patients with AD dementia, compared with 40 age matched cognitively normal controls (controls, aMCI and AD aged 70 years SD 5). Next, we studied the effects of BP lowering on CBF using a) one year exercise intervention (in aMCI) and b) BP lowering treatment with a calcium channel blocker (in AD dementia). Result at baseline, we found no evidence of impaired dynamic cerebral autoregulation in aMCI and AD compared to controls. BP lowering (on average ‐10 mmHg systolic BP) did not reduce global nor regional CBF in aMCI and AD. Of interest, BP lowering led to an increase in hippocampal CBF. Conclusion No evidence for impairment of cerebral autoregulation was found. BP lowering did not reduce CBF, in contrast, BP lowering may even improve regional and possibly global CBF. Further studies should extend these findings to a larger population and to earlier stages of AD.