Longitudinal blood pressure trajectories and tau‐lipid biomarkers associated with dementia in hypertensive adults: Results from the population‐based CRHCP cohort

INTRODUCTION: Blood pressure (BP) trajectories are associated with dementia, but their relevance across neurodegenerative and metabolic backgrounds in hypertensive populations remains unclear. METHODS: We analyzed 28,135 hypertensive participants from the China Rural Hypertension Control Project to estimate BP trajectories over 4 years using latent class group-based models. A nested case-control study was designed to assess interaction effects between BP trajectories and pTau217-lipid composite indices on dementia. RESULTS: Four BP trajectories were identified. In fully adjusted models, the high-stable diastolic BP trajectory showed the strongest association with dementia (odds ratio [OR] = 2.14, 95% confidence interval [CI] 1.74-2.63), followed by high-stable systolic BP trajectory (OR = 1.75, 95% CI 1.42-2.15). In the nested case-control analysis, significant interactions between pTau217-lipid composite indices and BP trajectories (high-declining and moderate-stable) were observed in relation to dementia. DISCUSSION: High-stable BP trajectories were consistently associated with dementia, whereas the associations between high-declining and moderate-stable BP trajectories varied according to pTau217-lipid composite indices.