A comprehensive analysis published in the Journal of the American Heart Association reveals that multiple types of cardiovascular disease (CVD) and CVD risk factors are associated with a higher risk of Alzheimer's disease, with low blood pressure (hypotension) showing the strongest connection. The study, which examined health data from nearly 800,000 adults in the UK Biobank and the US All of Us Research Program, underscores the importance of maintaining optimal cardiovascular health for brain health.
“By examining different types of heart disease individually, we identified which adults with heart disease might have the highest risk for cognitive decline. This highlights the importance of optimal cardiovascular health to possibly prevent Alzheimer's disease,” said Aili Toyli, B.S., lead author of the study and a student at Michigan Technological University in Houghton, Michigan.
Cardiovascular disease encompasses a range of conditions affecting the heart and blood vessels, including coronary heart disease, stroke, heart failure, atrial fibrillation (irregular heartbeat), and risk factors such as high and low blood pressure and Type 2 diabetes. Alzheimer's disease, the most common form of dementia, gradually impairs memory, thinking, and cognitive function. Inadequate blood flow to the brain reduces oxygen and nutrient delivery, fostering an environment conducive to the accumulation of Alzheimer's-related proteins like amyloid beta and tau.
Key findings from the analysis indicate that adults with hypotension in the UK Biobank were about three times more likely to develop Alzheimer's disease, and nearly twice as likely in the All of Us study, compared to those without low blood pressure. High blood pressure (hypertension) was associated with a 1.6 times higher likelihood of Alzheimer's disease across both datasets. Participants with a previous stroke had a 1.5 times higher risk in the UK Biobank and 1.85 times in All of Us. In the UK Biobank, those with atrial fibrillation were about 1.5 times more likely to have Alzheimer's disease. Notably, heart attacks were not significantly linked to an increased risk of Alzheimer's in either dataset.
The associations between CVD and Alzheimer's disease were stronger among Black and Hispanic participants compared to white participants, particularly for high blood pressure, where the risk was three times higher. “Compared to hypertension, hypotension receives a lot less attention overall, which likely leads to less data and less research focus. Detailed research is needed to understand the biological mechanisms that might be behind the links between Alzheimer’s and CVD. Once we determine the specific pathway that connects them, we may be able to intervene and break the chain before Alzheimer’s develops,” said Toyli.
Elisabeth Marsh, M.D., FAHA, chair of the American Heart Association’s 2026 Scientific Statement Brain Health Across the Lifespan, commented, “We’ve known for a long time that high blood pressure can have damaging long-term effects on the brain. This study shows us that blood pressure can also become a problem when it is too low for long periods of time. The brain needs blood to get the oxygen and nutrients it needs to function properly.” Marsh, who was not involved in the research, is a professor of neurology at The Johns Hopkins University School of Medicine.
The study analyzed data from the UK Biobank (over 502,000 adults, mostly of European descent) and the All of Us Research Program (over 287,000 adults from across the US, with diverse racial and ethnic backgrounds). Researchers examined links between Alzheimer's disease and ten types of CVD and risk factors, including hypertension, hypotension, chest pain, heart attack, pulmonary embolism, atrial fibrillation, heart failure, chronic rheumatic heart disease, chronic ischemic heart disease, and stroke. Lifestyle and health factors such as age, smoking, physical activity, and Type 2 diabetes were accounted for. However, because the data was collected at a single point in time, the study cannot establish whether CVD or Alzheimer's occurred first. Diagnoses were based on medical billing codes, which may have missed undiagnosed or incorrectly recorded conditions.
These findings emphasize the need for further research into the biological links between cardiovascular health and Alzheimer's disease. The American Heart Association's Life's Essential 8 metrics provide a framework for achieving optimal heart and brain health through factors like physical activity, diet, smoking status, sleep, body mass index, blood pressure, cholesterol, and blood sugar. This study adds to the growing evidence that managing cardiovascular health is crucial not only for heart health but also for preserving cognitive function as we age.
