Kevin S. Heffernan

Introduction: Compromised vascular health is increasingly linked to Alzheimer's disease (AD) risk. Estimated pulse wave velocity (ePWV), derived from age and blood pressure, and provides a practical, non‐invasive index of vascular stiffness and overall vascular health. Older African Americans experience a disproportionate burden of vascular disease and AD. Genetic risk factors such as APOE ε4 and ABCA7‐80 (rs115550680) further increase AD susceptibility. However, whether these genetic risks influence vascular stiffness and how that may interact with AD pathology remains unknown, especially in African Americans. Methods: A total of 143 older African Americans (mean age = 71.10 ± 6.83 years; 109 women) were included. We examined the effects of both ABCA7‐80 and APOE ε4 genotypes on ePWV and plasma phosphorylated tau 217 (p‐tau217). All regression models controlled for sex, education, pulse pressure, waist‐to‐hip ratio, global cognitive status, hypertension status, and APOE genotype (APOE genotype only used for ABCA7‐80 regression models). Results: ABCA7‐80 risk allele carriers exhibited higher ePWV ( F _(1,130) = 8.16, p  = 0.005, η ² _p   = 0.064) and higher p‐tau217 levels ( F _(1,130) = 30.11, p  < 0.001, η ² _p = 0.201). APOE ε4 allele carriers also showed higher p‐tau217 levels ( F _(1,131) = 12.96, p  < 0.001, η ² _p   = 0.092). ABCA7‐80 significantly moderated the relationship between ePWV and p‐tau217 (F _(1,130) = 6.58, p < 0.001), such that higher ePWV was associated with higher p‐tau217 among ABCA7‐80 risk carriers ( β  = 0.52, t ₍₁₃₀₎ = 2.69, p  = 0.008). Discussion: ABCA7‐80 risk, but not APOE ε4, heightens susceptibility to the tau‐related effects of compromised vascular health among older African Americans. These findings identify a genetically vulnerable subgroup in which vascular stiffness may disproportionately accelerate AD‐related tau pathology and highlight vascular health as a modifiable target for reducing AD risk in African Americans.

Han CJ, et al. Clin Hypertens. 2026 ;32:e45. https://doi.org/10.5646/ch.2026.32.e45

Objectives: Exposure to stressful and life‐threatening events before resettlement, coupled with the acculturation challenges of adjusting to an unfamiliar host country post‐relocation, may increase the risk for cardiovascular disease (CVD) in refugees. This pilot study examined the association between psychosocial‐demographic factors with central blood pressure (BP), an established independent predictor of CVD, among resettled refugees living in Syracuse, New York. Methods: One hundred fifty‐seven first‐generation resettled refugees receiving primary care services in the ambulatory Adult Medicine Clinic at an academic institution were recruited for the study during their clinic visit. Central systolic BP and pulse pressure (PP) were measured from brachial pulse wave analysis using a validated cuff‐based oscillometric device. The relationship between psychosocial‐demographic factors and central BP measures was assessed using forward stepwise linear regression. Results: Age ( β = 0.25, 95% CI 0.10–0.40) and BMI ( β = 0.77, 95% CI 0.39–1.16) were associated with an increased central systolic BP ( p < 0.05). Age ( β = 0.17, 95% CI 0.06–0.28) and BMI ( β = 0.38, 95% CI 0.13–0.62) were also associated with an increased central PP ( p < 0.05). Other psychosocial‐demographic factors such as non‐engagement in the workforce due to disability, smoking, alcohol use, mental health disorders, history of chronic disease, employment, and educational attainment were not associated with increased central BP. Conclusions: Among the various psychosocial‐demographic CVD risk factors assessed in our study, traditional risk factors age and BMI were significant predictors of central BP in resettled refugees.

INTRODUCTION: We examined the association between low‐frequency oscillations in blood pressure variability (LF‐BPV) at baseline (past) and 12 years later (concurrent) and BrainAGE gap (an indicator of brain health). METHODS: Participants were 110 adults (age range 37–83 years at baseline, 60% female) from the Midlife in the United States (MIDUS) study. LF‐BPV (0.04–0.15 Hz) was spectrally decomposed from beat‐to‐beat BP waveforms acquired from finger photoplethysmography. BrainAGE was estimated using a Gaussian‐process regression model applied to raw T1‐weighted magnetic resonance imaging (MRI) scans. BrainAGE gap was calculated as brain age minus chronological age. RESULTS: After adjustment for covariates, higher past diastolic LF‐BPV was associated with significantly reduced BrainAGE gap ( β = −2.24; 95% CI −4.15, −0.32, p = 0.022), as was higher concurrent diastolic LF‐BPV ( β = −1.90; 95% CI −3.68, −0.12, p = 0.037). CONCLUSION: Our findings suggest that low‐frequency oscillations in diastolic BPV are associated with slower brain aging relative to chronological age. Highlights: Low‐frequency oscillations in diastolic blood pressure variability, a marker of vasomotion, are reduced with aging. Low‐frequency oscillations in diastolic blood pressure variability are favorably associated with BrainAGE gap, a marker of overall brain health, measured from neuroimaging. Reductions in vasomotion with aging may contribute to accelerated brain aging relative to chronological age.

Tae Gu Choi, Jae Yeop Kim, Ho Jeong Min, Hyun Jeong Kim, Kanokwan Bunsawat, Setor K Kunutsor, Kevin S Heffernan, Sae Young Jae. KJSM 2025;43:1-12. https://doi.org/10.5763/kjsm.2025.43.1.1