Cerebrovascular disease, such as presence of white matter hyperintensities (WMH), contributes to Alzheimer’s disease (AD) pathology and progression. The antihypertensive nilvadipine may reduce WMH progression by reducing amyloid-induced vasoconstriction and improving cerebral perfusion. Here we show that in patients with mild to moderate AD, nilvadipine slows the increase of WMH after 6 months, but not after 18 months, when correcting for baseline WMH. This contradicts the view that reducing blood pressure in an elderly dementia population leads to progression of white matter damage and instead seems to have a beneficial effect on WMH.
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