Journal article
Long-Term Blood Pressure Variability and Risk of Cognitive Decline and Dementia Among Older Adults
Journal of the American Heart Association, Vol.10(13), pp.e019613-e019613
07/06/2021
DOI: 10.1161/JAHA.120.019613
PMCID: PMC8403315
PMID: 34176293
Abstract
BACKGROUND: Blood pressure variability (BPV) in midlife increases risk of late-life dementia, but the impact of BPV on the cognition of adults who have already reached older ages free of major cognitive deficits is unknown. We examined the risk of incident dementia and cognitive decline associated with long-term, visit-to-visit BPV in a post hoc analysis of the ASPREE (Aspirin in Reducing Events in the Elderly) trial.
METHODS AND RESULTS: ASPREE participants (N=19 114) were free of dementia and significant cognitive impairment at enrollment. Measurement of BP and administration of a standardized cognitive battery evaluating global cognition, delayed episodic memory, verbal fluency, and processing speed and attention occurred at baseline and follow-up visits. Time-to-event analysis using Cox proportional hazards regression models were used to calculate hazard ratios (HR) and corresponding 95% CI for incident dementia and cognitive decline, according to tertile of SD of systolic BPV. Individuals in the highest BPV tertile compared with the lowest had an increased risk of incident dementia and cognitive decline, independent of average BP and use of antihypertensive drugs. There was evidence that sex modified the association with incident dementia (interaction P=0.02), with increased risk in men (HR, 1.68; 95% CI, 1.19-2.39) but not women (HR, 1.01; 95% CI, 0.72-1.42). For cognitive decline, similar increased risks were observed for men and women (interaction P=0.15; men: HR, 1.36; 95% CI, 1.16-1.59; women: HR, 1.14; 95% CI, 0.98-1.32).
CONCLUSIONS: High BPV in older adults without major cognitive impairment, particularly men, is associated with increased risks of dementia and cognitive decline.
Details
- Title: Subtitle
- Long-Term Blood Pressure Variability and Risk of Cognitive Decline and Dementia Among Older Adults
- Creators
- Michael E. Ernst - University of IowaJoanne Ryan - Monash UniversityEnayet K. Chowdhury - Monash UniversityKaren L. Margolis - HealthPartnersLawrence J. Beilin - Royal Perth HospitalChristopher M. Reid - Monash UniversityMark R. Nelson - Menzies Research InstituteRobyn L. Woods - Monash UniversityRaj C. Shah - Rush University Medical CenterSuzanne G. Orchard - Monash UniversityRory Wolfe - Monash UniversityElsdon Storey - Monash UniversityAndrew M. Tonkin - Monash UniversityAmy Brodtmann - Florey Institute of Neuroscience and Mental HealthJohn J. McNeil - Monash UniversityAnne M. Murray - Berman Center for Outcomes and Clinical Research
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.10(13), pp.e019613-e019613
- DOI
- 10.1161/JAHA.120.019613
- PMID
- 34176293
- PMCID
- PMC8403315
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Publisher
- Wiley
- Number of pages
- 21
- Grant note
- U01AG029824; U19AG062682 / National Institute on Aging; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute on Aging (NIA) Victorian Cancer Agency National Cancer Institute at the National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Cancer Institute (NCI) 334047; 1127060 / National Health and Medical Research Council of Australia; National Health and Medical Research Council (NHMRC) of Australia Monash University
- Language
- English
- Date published
- 07/06/2021
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297457002771
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