INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Majestic Complex (Posters 61-120) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #87 Blood Pressure Variability and Plasma Alzheimer’s Disease Biomarkers in the Systolic Blood Pressure Intervention Trial Isabel Sible, University of Southern California, Los Angeles, United States Daniel Nation, University of Southern California, Los Angeles, United States Category: Dementia (Alzheimer's Disease) Keyword 1: clinical trials Keyword 2: dementia - Alzheimer's disease Objective: Elevated blood pressure variability is an emerging risk factor for dementia, independent of traditionally studied/targeted mean blood pressure levels. Recent evidence from observational cohorts suggests higher blood pressure variability is associated with Alzheimer’s disease biomarkers amyloid-beta (Aß) and tau, but less is known about relationships in interventional cohorts with strictly controlled mean blood pressure levels. We aimed to investigate the longitudinal relationship between blood pressure variability and change in plasma Alzheimer’s disease biomarkers under standard vs intensive blood pressure treatment. Participants and Methods: In this post hoc analysis of the Systolic Blood Pressure Intervention Trial, 457 participants (n = 206 in standard treatment group, n = 251 in intensive treatment group; mean [SD] age 70.0 [7.1] years; 42.2% female) underwent repeated blood pressure measurement between study baseline and 12-months follow-up. Participants also underwent venipuncture at baseline and follow-up (median [IQR] 3.5 [3.0 – 4.0] years after baseline) to determine plasma Alzheimer’s disease biomarkers total tau and Aß_1-42:Aß_1-40 Blood pressure variability was calculated as tertiles of variability independent of mean. Linear mixed models were used to investigate the effect of blood pressure variability x time on plasma Alzheimer’s disease biomarker levels. Identical analyses were performed with mean blood pressure to directly compare potential effects with blood pressure variability. Results: Higher blood pressure variability was associated with increased levels of plasma total tau in the standard treatment group (ß [95% CI] comparing 1^st vs 3^rd tertiles of blood pressure variability: .21 [.02, .41], p = .035), but not in the intensive treatment group (ß [95% CI] comparing 1^st vs 3^rd tertiles of blood pressure variability: -.02 [-.19, .16], p = .843). Blood pressure variability was not associated with plasma Aß_1-42:Aß_1-40 ratio in either treatment group. There were no significant associations between mean blood pressure and either plasma biomarker under standard or intensive treatment. Conclusions: Higher blood pressure variability was associated with increased plasma total tau under standard blood pressure treatment. Findings add new evidence to prior work linking blood pressure variability to Alzheimer’s disease pathophysiology in observational cohorts. Findings suggest that, despite strict control of mean blood pressure levels, blood pressure variability remains a risk for pathophysiological change underlying risk for Alzheimer’s disease, with potential therapeutic implications.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Majestic Complex (Posters 61-120)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #87

Blood Pressure Variability and Plasma Alzheimer’s Disease Biomarkers in the Systolic Blood Pressure Intervention Trial

Isabel Sible, University of Southern California, Los Angeles, United States
Daniel Nation, University of Southern California, Los Angeles, United States

Category: Dementia (Alzheimer's Disease)

Keyword 1: clinical trials
Keyword 2: dementia - Alzheimer's disease

Objective:

Elevated blood pressure variability is an emerging risk factor for dementia, independent of traditionally studied/targeted mean blood pressure levels. Recent evidence from observational cohorts suggests higher blood pressure variability is associated with Alzheimer’s disease biomarkers amyloid-beta (Aß) and tau, but less is known about relationships in interventional cohorts with strictly controlled mean blood pressure levels. We aimed to investigate the longitudinal relationship between blood pressure variability and change in plasma Alzheimer’s disease biomarkers under standard vs intensive blood pressure treatment.

Participants and Methods:

In this post hoc analysis of the Systolic Blood Pressure Intervention Trial, 457 participants (n = 206 in standard treatment group, n = 251 in intensive treatment group; mean [SD] age 70.0 [7.1] years; 42.2% female) underwent repeated blood pressure measurement between study baseline and 12-months follow-up. Participants also underwent venipuncture at baseline and follow-up (median [IQR] 3.5 [3.0 – 4.0] years after baseline) to determine plasma Alzheimer’s disease biomarkers total tau and Aß_1-42:Aß_1-40 Blood pressure variability was calculated as tertiles of variability independent of mean. Linear mixed models were used to investigate the effect of blood pressure variability x time on plasma Alzheimer’s disease biomarker levels. Identical analyses were performed with mean blood pressure to directly compare potential effects with blood pressure variability.

Results:

Higher blood pressure variability was associated with increased levels of plasma total tau in the standard treatment group (ß [95% CI] comparing 1^st vs 3^rd tertiles of blood pressure variability: .21 [.02, .41], p = .035), but not in the intensive treatment group (ß [95% CI] comparing 1^st vs 3^rd tertiles of blood pressure variability: -.02 [-.19, .16], p = .843). Blood pressure variability was not associated with plasma Aß_1-42:Aß_1-40 ratio in either treatment group. There were no significant associations between mean blood pressure and either plasma biomarker under standard or intensive treatment.

Conclusions:

Higher blood pressure variability was associated with increased plasma total tau under standard blood pressure treatment. Findings add new evidence to prior work linking blood pressure variability to Alzheimer’s disease pathophysiology in observational cohorts. Findings suggest that, despite strict control of mean blood pressure levels, blood pressure variability remains a risk for pathophysiological change underlying risk for Alzheimer’s disease, with potential therapeutic implications.