A new analysis published today in the Journal of the American Heart Association has identified a strong link between several cardiovascular conditions and Alzheimer's disease, with low blood pressure showing the most significant association. The study, which analyzed health records of nearly 800,000 adults from the UK Biobank and the All of Us Research Program in the U.S., found that individuals with hypotension were about three times more likely to develop Alzheimer's in the UK dataset and nearly twice as likely in the U.S. dataset compared to those without low blood pressure.
“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, B.S., lead author of the study and a student at Michigan Technological University. The study examined 10 types of cardiovascular disease and risk factors, including high blood pressure, low blood pressure, chest pain, heart attack, pulmonary embolism, irregular heartbeat, heart failure, chronic rheumatic heart disease, chronic ischemic heart disease, and stroke.
Across both datasets, high blood pressure was associated with a 1.6 times higher likelihood of Alzheimer's disease. Participants who had a previous stroke had a 1.5 times higher risk in the UK Biobank and 1.85 times in All of Us. Irregular heartbeat was linked to a 1.5 times increased risk in the UK Biobank. Notably, heart attacks were not significantly associated with Alzheimer's risk in either dataset.
The associations were particularly pronounced among Black and Hispanic participants. For high blood pressure, the link to Alzheimer's was three times stronger in these groups compared to white participants. This finding underscores the importance of addressing cardiovascular health disparities. The study also identified genetic links between cardiovascular disease and Alzheimer's, suggesting common biological pathways that warrant further research.
“We’ve known for a long time that high blood pressure can have damaging long-term effects on the brain,” said Elisabeth Marsh, M.D., FAHA, chair of the American Heart Association’s 2026 Scientific Statement on Brain Health Across the Lifespan. “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.” Marsh, who was not involved in the research, is a professor of neurology at The Johns Hopkins University School of Medicine.
The study's findings are based on data from the UK Biobank, with over 502,000 adults mostly of European descent, and the All of Us Research Program, with more than 287,000 adults from across the U.S. Diagnoses were derived from electronic health records using standardized billing codes. Because the data were collected at a single point in time, researchers cannot determine causality, and limitations include potential underdiagnosis or misclassification of conditions.
“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. Once we determine the specific pathway that connects them, we may be able to intervene and break the chain before Alzheimer’s develops,” said Toyli.
The American Heart Association emphasizes the importance of maintaining optimal cardiovascular health through its Life's Essential 8 metrics, which include physical activity, diet, smoking status, sleep habits, body mass index, blood pressure, cholesterol, and blood sugar. These findings reinforce the critical connection between heart health and brain health, suggesting that managing cardiovascular risk factors may be key to reducing Alzheimer's risk.
