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Published online before print February 18, 2009, doi:10.1212/01.wnl.0000345881.82856.d5)
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Received September 4, 2008
Accepted January 5, 2009

Less Alzheimer disease neuropathology in medicated hypertensive than nonhypertensive persons

L. B. Hoffman PhD*, J. Schmeidler PhD, G. T. Lesser MD, M. S. Beeri PhD, D. P. Purohit MD, H. T. Grossman MD, and V. Haroutunian PhD

From the Departments of Psychiatry (L.B.H., J.S., M.S.B., H.T.G., V.H.), Geriatrics and Adult Development (G.T.L.), and Pathology (D.P.P.), Mount Sinai School of Medicine, New York; Jewish Home & Hospital (G.T.L.), New York; and JJ Peters Veterans Affairs Medical Center (H.T.G., V.H.), Bronx, NY.


* To whom correspondence should be addressed. E-mail: lisa.b.hoffman{at}mssm.edu.

Objective: To test the hypothesis that use of antihypertensive medication is associated with lower Alzheimer disease (AD) neuropathology.

Methods: This was a postmortem study of 291 brains limited to those with normal neuropathology or with uncomplicated AD neuropathology (i.e., without other dementia-associated neuropathology) in persons with or without hypertension (HTN) who were and were not treated with antihypertensive medications. Neuritic plaque (NP) and neurofibrillary tangle (NFT) densities, quantified in selected brain regions according to the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropathologic criteria, with additional cortical NP counts, yielded 24 neuropathologic regional measures or summaries. Medicated hypertension (HTN-med; n = 77), nonmedicated HTN (HTN-nomed; n = 42), and non-HTN (no-HTN; n = 172) groups were compared by analyses of variance.

Results: The HTN-med group had significantly less neuropathology than the no-HTN group. The no-HTN group averaged over 50% higher mean NP and NFT ratings, and double the mean NP count, of the HTN-med group. The HTN-nomed group had significantly more neuropathology than the HTN-med group, but not significantly less than the no-HTN group.

Conclusions: There was substantially less Alzheimer disease (AD) neuropathology in the medicated hypertension group than the nonhypertensive group, which may reflect a salutary effect of antihypertensive medication against AD-associated neuropathology.


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