According to the latest research, high blood pressure, evidence of arterial disease and markers of inflammation in the blood in middle age appear more common in individuals whose parents have Alzheimer's disease than in individuals without a parental history of Alzheimer's.

Previous twin studies estimate that as much as 60 percent of the risk for Alzheimer's disease is under genetic control and other research has identified several vascular and inflammatory risk factors in midlife that may be associated with the later transition into cognitive decline related to Alzheimer's disease.

The researchers compared some of these vascular and inflammatory factors, such as high blood pressure and levels of pro-inflammatory proteins known as cytokines in the blood, between 206 offspring of 92 families with a history of Alzheimer's disease and 200 offspring of 97 families without a parental history of Alzheimer's. They measured blood pressure, obtained blood samples to assess genetic characteristics and levels of cholesterol, along with cytokines and other inflammation-related substances, and collected sociodemographic characteristics, medical history and information about diet, exercise and stress levels.

More individuals whose parents had Alzheimer's disease carried the APOE ε4 gene, known to be associated with Alzheimer's disease, than did those with no family history (47 percent vs. 21 percent). In addition, those with a family history had higher systolic (top number) and diastolic (bottom number) blood pressures, a lower ankle brachial index (ratio of ankle to arm systolic blood pressure, a sign of artery disease) and higher levels of several different pro-inflammatory cytokines. All of these positive associations were independent of APOE ε4 gene genotype.

The study concludes that high blood pressure and the expression of an innate pro-inflammatory cytokine profile in middle age are early risk factors of Alzheimer's disease in old age.

"As these risk factors cluster in families, it is important to realize that early interventions could prevent late-onset Alzheimer's disease. One could argue for a high-risk-prevention strategy by identifying the offspring of patients with Alzheimer's disease, screening them for hypertension and vascular factors and implementing various non pharmacological health measures" say the study authors.

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References:
1. Eric van Exel, et al. Vascular Factors and Markers of Inflammation in Offspring With a Parental History of Late-Onset Alzheimer Disease. Arch Gen Psychiatry. 2009;66(11):1263-1270.

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