{"doi":"10.1002/alz.14126","title":"White matter hyperintensity on MRI and plasma Aβ42/40 ratio additively increase the risk of cognitive impairment in hypertensive adults","abstract":"INTRODUCTION: Dementia often involves comorbid Alzheimer's and vascular pathology, but their combined impact warrants additional study. METHODS: We analyzed the Systolic Blood Pressure Intervention Trial and categorized white matter hyperintensity (WMH) volume into highest versus lowest/mid tertile and the amyloid beta (Aβ)42/40 ratio into lowest versus mid/highest ratio tertile. Using these binary variables, we created four exposure categories: (1) combined low risk, (2) Aβ risk, (3) WMH risk, and (4) combined high risk. RESULTS: In the cohort of 467 participants (mean age 69.7 ± 7.1, 41.8% female, 31.9% nonwhite or Hispanic) during 4.8 years of follow-up and across the four exposure categories the rates of cognitive impairment were 5.3%, 7.8%, 11.8%, and 22.6%. Compared to the combined low-risk category, the adjusted hazard ratio for cognitive impairment was 4.12 (95% confidence interval, 1.71 to 9.94) in the combined high-risk category. DISCUSSION: This study emphasizes the potential impact of therapeutic approaches to dementia prevention that target both vascular and amyloid pathology. HIGHLIGHTS: White matter hyperintensity (WMH) and plasma amyloid (Aβ42/40) are additive risk factors for the development of cognitive impairment in the SPRINT MIND trial. Individuals in the high-risk categories of both WMH and Aβ42/40 had a near fivefold increase in risk of cognitive impairment during 4.8 years of follow-up on average. These findings suggest that treatment strategies targeting both vascular health and amyloid burden warrant further research.","journal":"Alzheimer s & Dementia","year":2024,"id":443180,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9563,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":328345,"name":"Rebecca F. Gottesman","orcid":"0000-0002-9504-1256","position":1,"is_corresponding":false},{"id":1257807,"name":"Jeff D. Willamson","orcid":null,"position":2,"is_corresponding":false},{"id":1257808,"name":"Natalia Rost","orcid":null,"position":3,"is_corresponding":false},{"id":638055,"name":"Richa Sharma","orcid":"0000-0003-0462-661X","position":4,"is_corresponding":false},{"id":1228653,"name":"Vivian Wing‐yi Li","orcid":"0009-0004-3606-8426","position":5,"is_corresponding":false},{"id":1228652,"name":"Lauren Littig","orcid":"0009-0005-7389-0328","position":6,"is_corresponding":false},{"id":662896,"name":"Eric Stulberg","orcid":"0000-0002-3075-4597","position":7,"is_corresponding":false},{"id":256546,"name":"Guido J. Falcone","orcid":"0000-0002-6407-0302","position":8,"is_corresponding":false},{"id":379494,"name":"Shyam Prabhakaran","orcid":"0000-0003-0724-1694","position":9,"is_corresponding":false},{"id":466935,"name":"Andrea L.C. Schneider","orcid":"0000-0003-0026-5052","position":10,"is_corresponding":false},{"id":256547,"name":"Kevin N. Sheth","orcid":"0000-0003-2003-5473","position":11,"is_corresponding":false},{"id":295974,"name":"Nicholas M. Pajewski","orcid":"0000-0002-4447-6196","position":12,"is_corresponding":false},{"id":270469,"name":"Adam M. Brickman","orcid":"0000-0002-5125-8226","position":13,"is_corresponding":false},{"id":421725,"name":"Adam de Havenon","orcid":"0000-0001-8178-8597","position":0,"is_corresponding":true}],"reference_count":53,"raw_metadata":null,"created_at":"2026-07-19T02:01:24.471942Z","pmid":"39229896","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}