Alzheimer Dementia: Controlling blood pressure in middle age reduces the risk of dementia

Dementia is a major public health problem that places a huge burden on patients, their agents, and the national health care system.
The pathophysiological process leading to dementia begins many years before the appearance of clinically identifiable cognitive impairment later in life.

Therefore, prevention strategies should target the risk factors of middle age, which is roughly defined as between 40 and 65 years of age.
In fact, previous research supports different associations between middle-age (≤65 years) and late-life (>65 years) risk factors and the risk of dementia.
The American Heart Association (AHA) defines "Life Simple 7" (LS7), which is a system composed of three organisms (blood pressure, cholesterol level, blood sugar status) and four life>medsci.
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do?w=%E5%BF%83%E8%A1%80%E7%AE%A1">heart blood vessels composite score health (CVH) indicators for cardiovascular disease, primary or primary prevention.
Adherence to the ideal CVH recommendation of LS7 is associated with a lower risk of cardiometabolic diseases such as type 2 diabetes , myocardial infarction and stroke.
Whether adherence to these recommendations is also valuable for preventing dementia is still controversial.

Some cohort studies have explored the relationship between the LS7 score and the risk of dementia or cognitive decline in later life, but the results are not consistent.
Potential sources of inconsistency between studies include differences in sample characteristics and study design.
For example, the high age at the baseline assessment and the short follow-up time may cause bias due to the neglect of the long-term preclinical stage of dementia, leading to reverse causality.
This is concretely proven in the two components of the LS7 score-blood pressure and BMI.
In addition, despite strict adjustments to potential confounding factors, the analysis of observational studies is still prone to residual unmeasured confounding factors.
Therefore, evidence from observational data alone is not sufficient to determine the causal relationship between candidate risk factors and dementia risk, nor is it sufficient to support recommendations for preventive treatment.

Mendelian randomization (MR) uses genetic variants associated with the exposure of interest as a tool and investigates their relationship to disease outcomes, thereby overcoming some of the key limitations of observational research, such as confounding and reverse causality.
Therefore, MR allows inferences about causality.
Previous MR studies exploring the association between vascular risk factors and Alzheimer's disease (AD) failed to show a clear causal relationship, but the clinical diagnosis of AD dementia needs to exclude a large number of accompanying cerebrovascular diseases that may have a significant impact on cognition.
The genetic signal that represents the contribution of blood vessels to dementia is underrepresented in the genome-wide association study ( GWAS ) of AD, as shown in previous studies of coronary artery disease and AD.
In order to provide widely applicable dementia prevention strategies, in addition to more targeted MR research on dementia subtypes, MR research should mainly focus on the result of all-cause dementia.
Currently, such research does not currently exist.

In this way, Rainer Malik and others of the University of Munich used large-scale data from 230,000 individuals aged 40 to 69 years from the UK Biobank (UKB) to follow them for up to 12 years, aiming to:
(1 ) Determine the relationship between the baseline LS7 score and its biological and life>
(2) Determine the linear and non-linear relationship between individual vascular risk factors and the occurrence of all-cause dementia;
(3) Use MR Analysis to establish the causal relationship between individual vascular risk factors and all-cause dementia.

They found that compliance with the biological indicators of LS7 (blood pressure, cholesterol.

The significance of this study is that it has discovered the importance of controlling blood pressure in middle age to reduce dementia, and controlling blood pressure in middle age can reduce the risk of dementia.

Original source: onlinelibrary.