A new analysis published today in the Journal of the American Heart Association reveals that several types of cardiovascular disease (CVD) and CVD risk factors are associated with an increased risk of Alzheimer's disease, with low blood pressure showing the strongest connection. The study, which examined health data from nearly 800,000 adults in the UK Biobank and the All of Us Research Program, found that individuals with hypotension were about three times more likely to develop Alzheimer's in the UK cohort and nearly twice as likely in the U.S. cohort compared to those without low blood pressure.
"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.
The analysis assessed 10 cardiovascular conditions and risk factors, including high blood pressure, low blood pressure, chest pain, heart attack, pulmonary embolism, irregular heartbeat, heart failure, chronic rheumatic heart disease, chronic ischemic heart disease, and stroke. Across both datasets, adults with hypertension were 1.6 times more likely to have Alzheimer's disease. Participants who had a previous stroke faced a 1.5 times higher risk in the UK Biobank and 1.85 times in All of Us. Atrial fibrillation was linked to about 1.5 times higher likelihood of Alzheimer's in the UK Biobank. Notably, heart attacks were not significantly associated with increased Alzheimer's risk in either dataset.
The associations between CVD and Alzheimer's were stronger among Black and Hispanic participants compared to white participants, especially for hypertension, 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," Toyli said.
Elisabeth Marsh, M.D., FAHA, chair of the American Heart Association's 2026 Scientific Statement on Brain Health Across the Lifespan, who was not involved in the research, 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."
The study used data from the UK Biobank (over 502,000 adults, mostly European descent) and the All of Us Research Program (over 287,000 adults from across the U.S.). In the All of Us study, about 53% of participants were white, 20% Black, and 17% Hispanic. Researchers examined links between Alzheimer's and CVD conditions using electronic health records and standardized medical billing codes. Lifestyle factors such as age, smoking, physical activity, and Type 2 diabetes were accounted for. Because the data were from a single point in time, causality cannot be determined. The findings underscore the importance of maintaining cardiovascular health to potentially reduce Alzheimer's risk, as outlined in the American Heart Association's Life's Essential 8 metrics, which measure physical activity, diet, smoking status, sleep, body mass index, blood pressure, cholesterol, and blood sugar.
