A large-scale analysis published today in the Journal of the American Heart Association has found that multiple types of cardiovascular disease (CVD) and CVD risk factors are associated with a higher risk of Alzheimer's disease, with low blood pressure showing the strongest connection. The study, which examined health records from nearly 800,000 adults in the UK Biobank and the U.S. All of Us Research Program, provides new insights into the relationship between heart health and brain health.
Researchers analyzed data from more than 502,000 adults in the UK Biobank and over 287,000 adults in the All of Us program, looking at 10 types of CVD 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. They found that adults with hypotension in the UK Biobank were about three times more likely to develop Alzheimer's disease, and nearly twice as likely in the All of Us study, compared to those without low blood pressure.
"Compared to hypertension, hypotension receives a lot less attention overall, which likely leads to less data and less research focus," said lead author Aili Toyli, a student at Michigan Technological University. "Detailed research is needed to understand the biological mechanisms that might be behind the links between Alzheimer's and CVD."
Across both datasets, adults with hypertension were 1.6 times more likely to have 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. Those with atrial fibrillation were about 1.5 times more likely to develop Alzheimer's. Notably, heart attacks were not significantly linked to increased Alzheimer's risk.
The study also revealed stronger associations between CVD and Alzheimer's among Black and Hispanic participants compared to white participants, particularly for high blood pressure, where the risk was three times higher. "By examining different types of heart disease individually, we identified which adults with heart disease might have the highest risk for cognitive decline," Toyli added.
Dr. Elisabeth Marsh, chair of the American Heart Association's 2026 Scientific Statement on Brain Health Across the Lifespan, commented, "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."
The findings suggest that many heart and blood vessel conditions, especially those affecting blood flow, are strongly linked to brain health. Researchers also identified key locations in DNA linked to both CVD and Alzheimer's, indicating possible common biological roots. However, because the data is from a single point in time, causality cannot be determined.
The American Heart Association recommends achieving optimal cardiovascular health through its Life's Essential 8 metrics, which include physical activity, diet, smoking status, sleep, body mass index, blood pressure, cholesterol, and blood sugar. This study underscores the importance of managing cardiovascular risk factors to potentially reduce Alzheimer's risk.
