Association Between Short‐Term Blood Pressure Variability and the Alzheimer's Disease Continuum
Bibliographic record
Abstract
ABSTRACT Background Emerging evidence indicates that blood pressure variability (BPV) is a modifiable vascular risk factor for Alzheimer's disease (AD). Herein, we aimed to systematically evaluate the potential role of short‐term BPV across the AD continuum. Methods This study included 263 patients on the AD continuum from the Chinese Imaging, Biomarkers, and Lifestyle study between January 1, 2023, and December 31, 2023. 24‐h ambulatory blood pressure monitoring was performed to obtain blood pressure measurements and evaluate BPV. Partial Spearman's correlation and restricted cubic spline analysis were performed to assess the associations between BPV and neuropsychological tests, cerebrospinal fluid biomarkers, and multimodal neuroimaging measures, respectively. The mediating effects of multimodal neuroimaging measures on the association between BPV and neuropsychiatric symptoms (NPS) were analyzed. Results The elevated standard deviation (SD) and average real variability of nightly diastolic blood pressure (DBP) were correlated with higher Neuropsychiatric Inventory (NPI) scores ( r = 0.19, p = 0.034; r = 0.22, p = 0.013). The increased SD of nightly systolic blood pressure (SBP) was correlated with increased Hamilton Anxiety Scale (HAMA) scores and total tau levels ( r = 0.20, p = 0.026; r = 0.17, p = 0.027), and elevated coefficient of variation (CV) of nightly SBP was correlated with higher HAMA scores and lower Aβ 42/40 levels ( r = 0.20, p = 0.026; r = –0.18, p = 0.021). The nightly variability of SBP showed an inverted U‐shaped relationship with Montreal Cognitive Assessment scores ( P for nonlinear = 0.008; P for nonlinear = 0.015; P for nonlinear = 0.021). The left cuneus volume mediated 29.41% of the association between the CV of nightly SBP and HAMA scores, while the right medial orbitofrontal thickness mediated 35.44% of the association between the CV of nightly DBP and NPI scores. Conclusion This study suggests that short‐term BPV may play a role in the AD continuum. These findings provide evidence of a vascular pathway to AD, as well as a potential and accessible intervention target for patients on the AD continuum.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".