ArticleFrontiers in neuroscience2020
Pulse Pressure: An Emerging Therapeutic Target for Dementia.
Article in Frontiers in neuroscience, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 44 citations in OpenAlex.
- Early-life blood pressure and midlife brain and cognitive health: tests in two birth cohorts.Brain communications · 2026Article
- Relation between Cerebrospinal Fluid Catecholamines and Vascular Risk Factors, Thyroid Function and Vitamins in Healthy Individuals and Patients with Neurodegenerative Diseases.Current Alzheimer research · 2026Observational
- Blood pressure variability and parenchymal hematoma after endovascular thrombectomy: effect modification by recanalization status and cerebral small vessel disease burden.Frontiers in neurology · 2026Article
- Pulse Pressure Impairs Cognition via White Matter Disruption.Hypertension (Dallas, Tex. : 1979) · 2025Article
- Association of pulse pressure with presynaptic dysfunction in older adults with Alzheimer's disease: a cohort study.Scientific reports · 2025Article
- The pulsing brain: state of the art and an interdisciplinary perspective.Interface focus · 2025Review
- A Triple Mystery of Insidious Organ Failure: Are the Lung, Kidney and Brain All Damaged by the Ageing Pulse?Biomedicines · 2024Review
- Cognitive Outcomes in Young Adults with Primary Arterial Hypertension: The Role of Cardiovascular Risk Factors and Hypertension-Mediated Organ Damage.Medicina (Kaunas, Lithuania) · 2024Article
- A State-of-the-Art Review on the Role of Cognitive and Motor Reserve on Quality of Life: A Focus on Cardiovascular Patients in a Lifespan Perspective.Geriatrics (Basel, Switzerland) · 2024Review
- Genetic Complexities of Cerebral Small Vessel Disease, Blood Pressure, and Dementia.JAMA network open · 2024Article
- The impact of blood pressure variability on the development of parenchymal hematoma in acute cerebral infarction with atrial fibrillation.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Arterial stiffness mediates the association between age and processing speed at low levels of microvascular function in humans across the adult lifespan.American journal of physiology. Heart and circulatory physiology · 2024Article
- Pulsatility analysis of the circle of Willis.Aging brain · 2024Article
- Pulse pressure and APOE ε4 dose interact to affect cerebral blood flow in older adults without dementia.Cerebral circulation - cognition and behavior · 2024Article
- Cerebral microcirculatory pulse wave propagation and pulse wave amplitude mapping in retrospectively gated MRI.Scientific reports · 2023Article
- Vascular senescence and leak are features of the early breakdown of the blood-brain barrier in Alzheimer's disease models.GeroScience · 2023Article
- Persistent High Pulse Pressure in Acute Non-Cardiogenic Ischemic Stroke as a Predictor of Neurological Deterioration and Recurrence of Ischemic Stroke: ADS Post-Hoc Analysis.Journal of atherosclerosis and thrombosis · 2023Article
- Normative values of the brain health index in UK biobank.Neuroimage. Reports · 2023Article
- Article
- The Associations of Pulse Pressure and Mean Arterial Pressure on Physical Function in Older Americans.Geriatrics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Elevated pulse pressure can cause blood-brain barrier dysfunction and subsequent adverse neurological changes that may drive or contribute to the development of dementia with age. In short, elevated pulse pressure dysregulates cerebral endothelial cells and increases cellular production of oxidative and inflammatory molecules. The resulting cerebral microvascular damage, along with excessive pulsatile mechanical force, can induce breakdown of the blood-brain barrier, which in turn triggers brain cell impairment and death. We speculate that elevated pulse pressure may also reduce the efficacy of other therapeutic strategies for dementia. For instance, BACE1 inhibitors and anti-amyloid-β biologics reduce amyloid-β deposits in the brain that are thought to be a cause of Alzheimer's disease, the most prevalent form of dementia. However, upregulation of oxidative and inflammatory molecules and increased amyloid-β secretion by cerebral endothelial cells exposed to elevated pulse pressure may hinder cognitive improvements with these drugs. Additionally, stem or progenitor cell therapy has the potential to repair blood-brain barrier damage, but chronic oxidative and inflammatory stress due to elevated pulse pressure can inhibit stem and progenitor cell regeneration. Finally, we discuss current efforts to repurpose blood pressure medications to prevent or treat dementia. We propose that new drugs or devices should be developed to safely reduce elevated pulse pressure specifically to the brain. Such novel technologies may alleviate an entire downstream pathway of cellular dysfunction, oxidation, inflammation, and amyloidogenesis, thereby preventing pulse-pressure-induced cognitive decline. Furthermore, these technologies may also enhance efficacy of other dementia therapeutics when used in combination.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.