Midlife hypertension is associated with an increased risk of dementia in women
Female sex, early-onset hypertension, and risk of dementiaLiterature - Gilsanz P, Mayeda ER, Glymour MM, et al. - Neurology 2017, published online ahead of print
- After adjusting for demographics, early-adulthood hypotension (HR: 1.30; 95% CI: 0.42–4.04), pre-hypertension (HR: 1.04; 95% CI: 0.86–1.26), and hypertension (HR: 1.06; 95% CI: 0.85–1.32) were not associated with the risk of dementia.
- In similar models, midlife hypertension was associated with the risk of dementia (HR: 1.36; 95% CI: 1.10–1.67), but pre-hypertension (HR: 1.07; 95% CI: 0.88–1.30) or hypotension (HR: 0.61; 95% CI: 0.08–4.48) were not.
- In mid-adulthood, hypertension among women was associated with a 65% increased dementia risk (95% CI: 1.25–2.18) compared to normotensive women, which was not the case among men. The estimated effects remained similar when further adjusting for late-life conditions.
- The cumulative 25-year dementia risk at the age of 60 was 21% (95% CI: 12%–27%) for women with early-adulthood hypertension and 18% (95% CI: 14%–21%) for those without hypertension.
- Compared to women who remained normotensive during early- and mid-adulthood, onset of hypertension and persistent hypertension were associated with a 73% (95% CI: 1.24–2.40) and a 63% (95% CI: 1.11–2.40) increased risk of dementia.
- The association between mid-adulthood hypertension and dementia risk among women remained significant after further adjusting for mid-adulthood BMI and early or mid-adulthood smoking (HR: 1.59; 95% CI: 1.19–2.13).
Although midlife hypertension is more common in men, it was only associated with the risk of dementia in women. These findings may have important implications for hypertension management for women in their early 40s and brain health in later life.