June 15, 2026, 3:01 pm | Read time: 7 minutes
Alzheimer and cardiovascular diseases are considered two of the biggest health issues in old age. It has been known for years that both are closely linked. Data from two large patient cohorts reveal a surprising finding: Many people have both low blood pressure and Alzheimer’s simultaneously. Has hypotension been underestimated in Alzheimer’s research?
Study: Alzheimer’s Risk Highest with Low Blood Pressure
Researchers from Michigan Technological University, the National Institutes of Health, and the American Heart Association compared the ten most common cardiovascular diseases with Alzheimer’s risk. The results showed that almost all had a significant connection to an increased Alzheimer’s risk. Surprisingly for the researchers, low blood pressure showed a much stronger connection to Alzheimer’s in the white population than high blood pressure. The renowned Journal of the American Heart Association reported.1
The large-scale cross-sectional study is based on datasets from 789,144 individuals from the UK Biobank and the U.S. All of Us Research Program, two of the world’s largest health databases. The participants’ data were collected between 2006 and 2010 and in 2015. The researchers, led by Prof. Weihua Zhou, an expert in medical informatics, examined the connection between Alzheimer’s and cardiovascular diseases using statistical models. Diagnoses were sourced from electronic medical records. In the case of the UK Biobank data, there were at least 10,000 cases per disease.
Alzheimer: These 10 Cardiovascular Diseases Are Involved
The researchers compared these ten cardiovascular diseases with Alzheimer’s risk:
- Hypertension (high blood pressure)
- Hypotension (low blood pressure)
- Angina pectoris (chest tightness)
- Acute myocardial infarction (heart attack)
- Pulmonary embolism
- Heart rhythm disorders (e.g., atrial fibrillation)
- Heart failure (heart weakness)
- Chronic rheumatic heart disease
- Chronic ischemic heart disease
- Cerebral infarction (ischemic stroke)
Video: Cardiologist: “Heart rhythm disorders can generally be cured”
To obtain the most reliable results, the research team considered numerous influencing factors such as age, gender, ethnic background, lifestyle factors (such as smoking and physical activity), and comorbidities like diabetes. A genetic analysis was also conducted to examine the role of certain gene variants in both cardiovascular and neurological diseases.
Participants with Alzheimer’s were generally older than the control groups in both studies.
Key Findings: Alzheimer’s Risk Nearly Tripled with Hypotension
Almost all of these diseases–except for acute myocardial infarction and chronic rheumatic heart disease–showed a significant connection to an increased Alzheimer’s risk in the analysis. Low blood pressure was the strongest and most consistent risk factor in both databases studied. In the UK Biobank, the Alzheimer’s risk for patients with hypotension was nearly three times higher than the control group (factor 2.74). In the U.S. “All of Us” cohort, the risk was twice as high (factor 1.97). It is important to note that these strong values were primarily observed in the white population. In Black and Hispanic participants, high blood pressure (hypertension) was the dominant risk factor for Alzheimer’s.
When is it low blood pressure?
Hypotension is defined as blood pressure values below 100/60 mmHg for women and below 110/70 mmHg for men.
For comparison: The optimal blood pressure for a healthy adult is about 120/80 mmHg.
Further Results
In the U.S. cohort, cerebral infarction had a stronger connection to Alzheimer’s with a factor of 1.85 than high blood pressure, but it still lagged behind low blood pressure. High blood pressure and heart rhythm disorders were associated with an approximately 1.5-fold increased Alzheimer’s risk across both cohorts.
Heart failure and chronic ischemic heart disease were also significantly associated with Alzheimer’s. However, the effects were less than those of blood pressure changes or strokes.
The researchers did not find a connection between all cardiovascular diseases and Alzheimer’s. For acute heart attack and chronic rheumatic heart diseases, no significant direct connection could be proven across different population groups.
According to the scientists, a heart attack could indirectly affect mental health, for example, through damage to blood vessels or reduced blood flow to the brain. However, they could not establish a direct link to the biological processes that cause Alzheimer’s.
What the Gene Study Showed
The researchers found a total of 164 unique pairs of gene variants that are in close proximity to each other in both Alzheimer’s and cardiovascular diseases. The strongest overlaps were between Alzheimer’s and angina pectoris, the thickness of the heart muscle wall, and coronary heart disease. These findings suggest that the heart and brain communicate through common signaling pathways, such as inflammatory processes or the regulation of vascular function.
Significance of the Study – What the Authors Say
“Both chronic and orthostatic hypotension have been linked to cerebral hypoperfusion [reduced blood flow to the brain, ed. note], oxidative stress, and tau pathology–mechanisms that could worsen or accelerate the progression of Alzheimer’s,” the study states. Additionally, the researchers emphasize in their conclusion the clinical relevance of this previously neglected danger: “These results […] suggest that certain cardiovascular subtypes, particularly hypotension, may play an underestimated role in cognitive decline.”
The study authors’ thesis: Too low blood pressure could endanger the adequate supply of the brain. Reduced cerebral blood flow can contribute to oxygen deficiency, oxidative stress, and possibly changes associated with Alzheimer’s. At the same time, Alzheimer’s itself could affect blood pressure regulation through disturbances of the autonomic nervous system. The relationship could thus go both ways.
The study provides an important social medical explanation for the deviations in Black and Hispanic participants. The researchers suspect that socioeconomic barriers and limited access to blood pressure treatments in Black and Hispanic populations lead to high blood pressure playing a more destructive role in brain health than in the white population.
Simple Morning Routine to Reduce Risk of Fatal Stroke
How the Biorhythm Can Significantly Impact Training Success
Study Context and Possible Limitations
The study is one of the largest to date on the connection between cardiovascular diseases and Alzheimer’s. It is particularly significant that the researchers considered various cardiovascular diseases individually and that the results were similar in two very different population groups.
Study Shows Connection, Not Causation
The researchers were able to determine that many people had both low blood pressure and Alzheimer’s simultaneously, but they could not determine whether low blood pressure came first or if Alzheimer’s disrupted blood pressure regulation. The authors themselves emphasize that their data cannot clarify the chronological order. Since many affected individuals have multiple cardiovascular diseases simultaneously, the influence of individual factors–such as low blood pressure–is difficult to fully isolate.
Overall, the study provides important clues that need to be verified in further investigations. It should be clarified whether treating low blood pressure can actually influence Alzheimer’s risk. Consequently, blood pressure control–in both directions–should be a central pillar of Alzheimer’s prevention.
Signs and Causes of Low Blood Pressure (Hypotension)
Affected individuals often notice low blood pressure through a range of physical complaints, primarily resulting from reduced blood flow. The most common symptoms include:
- severe fatigue
- dizziness to the point of blacking out (especially when changing positions, such as from lying down to standing up)
- headaches and concentration problems
- feeling cold in hands and feet
- shortness of breath, a feeling of tightness or stabbing in the chest, and heart palpitations can also occur
Blood pressure generally drops when the blood volume is too low relative to the width of the arteries, meaning not enough blood is pumped through the body. Predisposition is the most common reason for low blood pressure. Here are the causes of hypotension:
- predisposition (particularly common in young women)
- consequence of other diseases (e.g., heart failure or hypothyroidism)
- consequence of factors such as insufficient water intake, severe vomiting, diarrhea, or high fever
- a sudden drop in blood pressure when standing up, as blood pools in the legs and temporarily less blood returns to the heart.
Find out here if low blood pressure is dangerous and what can be done about the symptoms.