2025 Volume 42 Issue 3 Pages 418-421
Anti–amyloid β (Aβ) antibody therapy for Alzheimer disease (AD) has been approved, and amyloid–related imaging abnormalities (ARIA), an adverse event of this treatment, have become widely known. The occurrence of ARIA is based on cerebral amyloid angiopathy (CAA) which is pathologically seen in most AD. CAA is one of the major pathologies of cerebral small vessel disease (SVD) and is classified as type 2 SVD. While type 1 SVD, which is most common type of SVD related to hypertension. Type 1 SVD and type 2 SVD could coexist and crosstalk with each other. Hypertension seems to be related to ARIA, and it has also been reported that lowering blood pressure is a preventive factor for ARIA. Further study is needed to determine whether type 1 SVD promotes ARIA during anti–Aβ therapy, and whether interventions to reduce the risk of type 1 SVD, including lowering blood pressure, are effective in preventing CAA and ARIA.
