These findings align with previous research demonstrating the detrimental impacts of hypertension on brain health in females.41 While we accounted for medication use in our supplementary analyses, data on the type of medication (e.g., cardiovascular-related vs other health-related) could further clarify the relationship between BP, APOE4 status, and brain health in males and females over time. This evidence concerns the gene APOE and hypertensive disorder.