Original Research Article Dement Geriatr Cogn Disord 2001;12:33–39 Blood Pressure and Risk of Dementia: Results from the Rotterdam Study and the Gothenburg H-70 Study Annemieke Ruitenberg a Ingmar Skoog d Alewijn Ott a,b Olafur Aevarsson d Jaqueline C.M. Witteman a Bodil Lernfelt e Frans van Harskamp c Albert Hofman a Monique M.B. Breteler a Departments of a Epidemiology and Biostatistics, b Medical Microbiology and Infectious Diseases and c Neurology, Erasmus University Medical Centre, Rotterdam, The Netherlands; d Institute of Clinical Neuroscience, Department of Psychiatry, Sahlgrenska Hospital, University of Göteborg, and e Department of Geriatric Medicine, Vasa Hospital, Göteborg, Sweden Accepted: March 20, 2000 Dr. M.M.B. Breteler Department of Epidemiology and Biostatistics Erasmus University Medical Centre, PO Box 1738 NL–3000 DR Rotterdam (The Netherlands) Tel. +31 10 4087489, Fax +31 10 4089382, E-Mail breteler@epib.fgg.eur.nl ABC Fax + 41 61 306 12 34 E-Mail karger@karger.ch www.karger.com © 2001 S. Karger AG, Basel 1420–8008/01/0121–0033$17.50/0 Accessible online at: www.karger.com/journals/dem Key Words Alzheimer disease W Blood pressure W Hypertension W Incidence study W Prospective study Abstract The association between blood pressure and dementia is debated. Results from population-based studies on blood pressure and dementia are inconclusive, and most are performed in subjects younger than 80 years of age. We examined the relation between blood pressure and dementia and the possible effect modification of this relation by age in a pooled dataset based on two pro- spective population-based studies. Subjects came from the Rotterdam study (n = 6,668), a longitudinal popula- tion-based study among subjects aged 55 years and over, and from the Gothenburg H-70 Study (n = 317), a study on subjects aged 85 years at baseline. Screening and diagnostic procedures for assessment of dementia were similar at baseline and follow-up and comparable between studies. We estimated relative risks of dementia using Cox proportional hazards regression analysis, ad- justed for age, gender and study location. The average follow-up was 2.1 years. During this period, 196 subjects developed dementia. The risk of dementia decreased with increasing blood pressure level (per 10 mm Hg sys- tolic blood pressure: RR = 0.93, 95% CI = 0.88–0.99; per 10 mm Hg diastolic blood pressure: RR = 0.89, 95% CI = 0.79–1.00). This association was confined to subjects who used anthypertensive medication. Persons who were demented at baseline had a stronger blood pres- sure decline during follow-up than those who were non- demented. This study suggests an inverse association between blood pressure and dementia risk in elderly per- sons on antihypertensive medication. Possibly, they may need higher blood pressure levels to maintain an ade- quate cerebral perfusion. Alternatively, lower blood pressure may be secondary to brain lesions in preclinical stages of dementia. Copyright © 2001 S. Karger AG, Basel Downloaded by: University of Groningen 192.87.23.101 - 12/23/2014 1:00:46 PM