Low Blood Pressure Shows Strongest Link to Alzheimer's Risk in New Analysis of Nearly 800,000 Adults
A new study in the Journal of the American Heart Association finds that hypotension is most strongly associated with Alzheimer's disease among several cardiovascular conditions, with stronger effects in Black and Hispanic adults, suggesting shared biological roots.
A comprehensive analysis of health data from nearly 800,000 adults in the U.K. and U.S. has revealed that several cardiovascular conditions and risk factors are associated with an increased risk of Alzheimer's disease, with low blood pressure showing the strongest connection. The findings, published today in the Journal of the American Heart Association, underscore the importance of maintaining optimal cardiovascular health for brain health.
Researchers examined the links between Alzheimer's disease and 10 types of cardiovascular disease and risk factors, including high blood pressure, low blood pressure, stroke, irregular heartbeat, and heart failure. The study used data from the UK Biobank, containing over 502,000 adults mostly of European descent, and the All of Us Research Program, with over 287,000 adults from across the U.S.
Among the key findings, adults with hypotension in the UK Biobank were about three times more likely to develop Alzheimer's, and nearly twice as likely in the All of Us study, compared to individuals without low blood pressure. Hypertension was associated with a 1.6 times higher risk across both datasets, while previous stroke increased risk by 1.5 times in the UK Biobank and 1.85 times in All of Us. Atrial fibrillation was linked to about 1.5 times higher risk in the UK Biobank.
Notably, the associations between cardiovascular disease and Alzheimer's were stronger among Black and Hispanic participants compared to white participants, especially for hypertension, where the risk was three times higher. Heart attacks were an exception, showing no significant link to Alzheimer's risk in either dataset.
“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, lead author of the study and a student at Michigan Technological University.
The study also found key places in some individuals’ DNA linked to both cardiovascular disease and Alzheimer's, suggesting common biological roots. However, researchers caution that more research is needed to understand the mechanisms. “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,” Toyli added.
Dr. Elisabeth Marsh, 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 American Heart Association recommends using Life's Essential 8 metrics to achieve optimal heart health and reduce cardiovascular disease risk. These metrics include physical activity, diet, smoking status, sleep habits, body mass index, blood pressure, cholesterol, and blood sugar.
Because the data analyzed is from a single point in time, researchers cannot determine if cardiovascular disease or Alzheimer’s came first. Other limitations include reliance on medical billing codes, which may miss undiagnosed conditions, and the fact that many participants had multiple cardiovascular conditions, complicating the measurement of individual impact.