,47 Neuroimaging studies show that high pulse pressure and/or ankle pressure is associated with greater white matter hyperintensity burden, hippocampal atrophy, and accelerated amyloid deposition.46, 47, 48, 49 Significant multiplicative interaction effects of sex with APOE ε4, and APOE ε4 with pulse pressure in women were observed, but not in men. This evidence concerns the gene APOE and hippocampal atrophy.