Interarm differences in systolic blood pressure and the risk of dementia and subclinical brain injury

Introduction: This study examined whether inter-arm differences in systolic blood pressure (IDSBP) ≥10mmHg were associated with the risk of incident dementia and subclinical brain injury. Methods: Between 1992 and 1998, 2063 participants of the Framingham Heart Study underwent assessment of IDSBP with results related to the 10 year risk of incident dementia including clinically characterized Alzheimer’s disease. Secondary outcomes included markers of subclinical brain injury on MRI. Results: High IDSBP were associated with a greater risk of incident dementia (HR 1.92; 95% CI: 1.09, 3.40) and Alzheimer’s disease (HR 2.32; 95% CI: 1.29, 4.18), but only in those who carried an APOE ε4 allele. IDSBP also predicted lower total brain volumes and more prevalent silent brain infarcts in those who were APOE ε4 positive. Discussion: High IDSBP were associated with an increased risk of dementia, including clinical Alzheimer’s disease, and subclinical brain injury in those who were APOE ε4 positive