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Abstract：
Hypertension is an important risk factor for Alzheimer\'s disease (AD) and all-cause dementia. The mechanisms underlying this association are unclear. Hypertension may be associated with AD neuropathological changes (ADNC), but reports are sparse and inconsistent. This systematic review included 15 autopsy studies (n = 5879) from observational cohorts. Studies were highly heterogeneous regarding populations, follow-up duration, hypertension operationalization, neuropathological methods, and statistical analyses. Hypertension seems associated with higher plaque and tangle burden, but results are inconsistent. Four studies (n = 3993/5879; 68%), reported clear associations between hypertension and ADNC. Another four suggested that antihypertensive medication may protect against ADNC. Larger studies with longer follow-up reported the strongest relationships. Our findings suggest a positive association between hypertension and ADNC, but effects may be modest, and possibly attenuate with higher hypertension age and antihypertensive medication use. Investigating interactions among plaques, tangles, cerebrovascular pathology, and dementia may be key in better understanding hypertension\'s role in dementia development.
摘要：
高血压是阿尔茨海默病(AD)和全因痴呆的重要危险因素。这种关联的潜在机制尚不清楚。高血压可能与AD神经病理学改变（ADNC）有关，但报告是稀疏和不一致的。这项系统评价包括来自观察性队列的15项尸检研究（n=5879）。关于种群的研究高度异质性，随访持续时间,高血压手术，神经病理学方法，和统计分析。高血压似乎与更高的斑块和缠结负担有关，但结果不一致。四项研究（n=3993/5879；68%），报道了高血压和ADNC之间的明确关联。另外四个建议抗高血压药物可以预防ADNC。随访时间较长的大型研究报告了最强的关系。我们的研究结果表明，高血压和ADNC之间存在正相关，但效果可能不大,并可能随着高血压年龄和抗高血压药物的使用而减弱。调查斑块之间的相互作用，缠结,脑血管病理学，和痴呆可能是更好地了解高血压在痴呆发展中的作用的关键。
