ALTERED PERICYTE MORPHOLOGY AND NG2 EXPRESSION IN HIPPOCAMPUS OF PATIENTS WITH ALZHEIMER'S DISEASE

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lowering medication on both blood pressure variability and cognitive function. We studied the association of different classes of blood pressure lowering medication with blood pressure variability and cognitive function and decline, independent of average blood pressure. Methods: We prospectively studied 2,229 participants from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER), who used only one blood pressure lowering medication. Blood pressure was measured at baseline and every three months during an average period of 3.3 years follow-up at the study center; blood pressure variability was defined as the standard deviation of all blood pressure measurements during follow up. Cognitive function was tested at baseline and repeatedly during follow-up using the Stroop test, Letter-Digit Coding test and immediate and delayed Picture-Word Learning tests.Results: Participants taking thiazide diuretics had the lowest systolic blood pressure variability and participants taking ACE-inhibitors had the highest systolic blood pressure variability (mean (SE) 14.16 (0.23) vs. 15.28 (0.25) mmHg respectively, p-value between classes 1⁄40.005). This association remained significant after additional adjustments for average systolic blood pressure and cardiovascular diseases and risk factors. No significant differences on all four cognitive tests were found at baseline between medication classes (p-value between classes >0.05). Participants taking loop diuretics showed the steepest decline on Stroop test (mean annual change (SE) 1.77 (0.52) and immediate Picture-Word Learning test (-0.07 (0.04), while participants taking ACE-inhibitors showed the least decline on both tests (-0.04 (0.29) vs. 0.03 (0.02), p-value between classes respectively 1⁄4 0.002 and 0.019). Conclusions: Although blood pressure lowering medication class was associated with blood pressure variability, medication could not explain the relationship between blood pressure variability and cognitive impairment.