{"doi":"10.1002/alz.70739","title":"Relationship of antihypertensives with late‐life cognitive decline and neuropathology","abstract":"INTRODUCTION: Antihypertensives (AHTs) are commonly used to treat high blood pressure and other conditions, but their associations with cognitive decline and common age-related neuropathologies are not well understood. METHODS: More than 3300 participants from three harmonized community-based cohorts without baseline dementia were evaluated annually for changes in cognition and > 1800 participants were analyzed for post mortem neuropathology. RESULTS: In a linear mixed effect model adjusted for age, sex, education, and race/ethnicity, AHT use was associated with higher baseline global cognition (p < 0.001) and slower decline (p = 0.002) in global cognition, episodic memory, and semantic memory (all p < 0.02) compared to non-use. In the autopsy group AHT use was associated with a lower tau tangle density (p = 0.004), but not with other neurodegenerative or cerebrovascular pathologies. These associations did not change after controlling for blood pressure or other comorbidities. DISCUSSION: AHT use is associated with slower cognitive decline and lower tau pathology in late life. HIGHLIGHTS: In this prospective study of > 3200 older, community-dwelling, persons followed for a mean of 8.6 years, those who used antihypertensive (AHT) medications during the study had slower cognitive decline, especially in episodic memory and semantic memory, compared to non-users. Among the > 1800 deceased and autopsied persons, AHT medication use was associated with fewer paired helical filament-positive tau tangles (a marker of Alzheimer's disease) but not with other neurodegenerative or cerebrovascular pathologies, compared to non-users. Based on observational data from a large dataset, AHT use in older persons was related to slower cognitive decline and less Alzheimer's disease pathology.","journal":"Alzheimer s & Dementia","year":2025,"id":536745,"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":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9078,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":282970,"name":"Ana W. Capuano","orcid":"0000-0002-3505-344X","position":1,"is_corresponding":false},{"id":227035,"name":"Rupal I. Mehta","orcid":"0000-0003-4917-6907","position":2,"is_corresponding":false},{"id":1068044,"name":"Lisa Laverne Barnes","orcid":null,"position":3,"is_corresponding":false},{"id":778,"name":"David A. Bennett","orcid":"0000-0003-3689-554X","position":4,"is_corresponding":false},{"id":282969,"name":"Zoe Arvanitakis","orcid":"0000-0001-7477-8884","position":5,"is_corresponding":false},{"id":1067459,"name":"Ajay Sood","orcid":"0000-0002-9153-6198","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:52:09.056872Z","pmid":"40994416","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":[]}