Association of pulse pressure with incidence of dementia independent of established risk factors

Overview

1. Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
2. MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, CB2 7EF, UK
3. Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
4. School of Public Health, Zhejiang University, Hangzhou, 310058, China
5. Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK; Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, CB2 0AW, UK
6. Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, CB2 7EF, UK
7. Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK; Department of Psychology, University of Cambridge, Cambridge, CB2 3EB, UK

Abstract

Objectives: To investigate the association between pulse pressure and dementia incidence, independent of other blood pressure measurements and established risk factors, and to assess whether this association differs across dementia subtypes.

Design: Prospective population-based study.

Setting: UK Biobank.

Participants: Of the 502,211 participants in the UK Biobank, 470,986 completed at least one blood pressure measurement and were included in the analysis. These participants were recruited between March 2006 and July 2010 and were followed for up to four assessments through to February 2024.

Main outcome measures: Incidence of dementia, identified through linked health records using ICD-9 and ICD-10 diagnosis codes, self-reported diagnoses or records of dementia-specific medication use.

The association between pulse pressure and risk of dementia was investigated using Cox proportional hazard models. Models were adjusted for age, sex, education, hearing problems, lipid levels, depression, traumatic brain injury, physical activity, diabetes, smoking, hypertension, body mass index, alcohol consumption and mean arterial pressure. Dementia subtype-specific associations were examined using competing risk models, with cause-specific Cox analyses included as supplementary sensitivity analyses.

Results: During a median follow-up of 13 years, 9,028 persons developed dementia (Alzheimer’s disease: 3,011; Vascular dementia: 1,270; Dementia with Lewy bodies: 234; Frontotemporal dementia: 191; Other/Mixed dementia: 4,322). Each 10mm Hg increase in pulse pressure was associated with a 5.4% higher risk of dementia (95% confidence interval on hazard ratio: 1.036 to 1.071), even after adjustment for age, mean arterial pressure and other established dementia risk factors. The effects were disproportionately stronger for Alzheimer’s disease and vascular dementia, with no clear evidence for increased risk for dementia with Lewy bodies or frontotemporal dementia. Results were robust across sensitivity analyses including alternative blood pressure metrics, complete-case models, and alternative dementia classifications.

Conclusions: Pulse pressure is independently associated with incidence of dementia beyond conventional blood pressure measures.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

The paper's code and data availability statement is in the Data section.

Tracing map

A tracing map links a paper to the code its authors published: this paper has none (its code is available on request), so it has no map.

Data

No dataset and no data link were found in the paper.

Data sharing

The data used in this study are available from the UK Biobank upon application by qualified researchers. Statistical code is available from the corresponding author upon reasonable request.

Reproduced under the paper's license (CC BY-NC), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 1, 28 September 2026: the first record

Recorded: type, journal, dates, 9 authors, 3 funders, 25 references.

Cite

This paper

Fang, Y., Henson, R. N., AI Bethlehem, R., Whiteside, D. J., Zhang, H., Dounavi, M.-E., Stamatakis, E. A., Rowe, J. B., & Tsvetanov, K. A. (2026). Association of pulse pressure with incidence of dementia independent of established risk factors. medRxiv (preprint). https://doi.org/10.64898/2026.05.20.26353580

Similar papers

The papers with a page that share the most with this one: the tools found in their code, their categories, datasets, cited references and authors, the rarest counting most.

[1] doi:10.1038/s42003-026-10282-0 [code]

Genetic risk of Alzheimer's disease is associated with loss of brain network segregation in midlife.

Journal: Communications biology

In common: Alzheimer's / dementia, clinical / translational, author Richard N Henson

[2] doi:10.1162/imag.a.1242 [code]

Stable individual differences dominate adult brain volume variation until later life.

Journal: Imaging neuroscience (Cambridge, Mass.)

In common: author Richard N Henson

[3] doi:10.3389/fnagi.2026.1862742

A brief checklist of modifiable dementia risk factors (RF12): associations with cognitive and affective measures in an Italian cohort.

Journal: Frontiers in aging neuroscience

In common: Alzheimer's / dementia, clinical / translational, 1 reference

[4] doi:10.1111/acel.70659

Effects of Physical Activity on Brain White Matter Integrity Are Region-, Dose-, and Age-Dependent: Findings From the Population-Based Rhineland Study.

Journal: Aging cell

In common: clinical / translational, 1 reference

[5] doi:10.1162/imag.a.1174 [code]

Retinal nerve fibre layer thickness reflects characteristics of brain grey and white matter.

Journal: Imaging neuroscience (Cambridge, Mass.)

In common: clinical / translational, 1 reference

[6] doi:10.1093/braincomms/fcag172 [code]

Early-life blood pressure and midlife brain and cognitive health: tests in two birth cohorts.

Journal: Brain communications

In common: 1 reference

Contribute

The authors of this paper can claim it, correct its record and validate its tracing map, and the maintainers of its code (its owner, or a public member of its organization) correct what it says of their repository; anyone signed in can ask for its removal. Every request goes to OSCR's own machine, which answers it; your account page follows them.

Request its removal

To ask OSCR to remove this record, the copies of its authors' scripts or its tracing map, use the removal request page: signed in, you say who you are, what to remove and why, then review and confirm the request. Published rules decide every request (how).

Discussion: questions and error reports about this paper and its code, from signed-in readers and its authors. It opens with sign-in.

Reproductions: reports from readers who ran the authors' code: what they reproduced, with which environment, commit and data. It opens with sign-in.

Activity: what happens around this paper: new versions of its record, its map's validation, discussions and reproductions. It opens with sign-in.