4.7 Article

Greater Blood Pressure Variability Is Associated With Lower Cognitive Performance The Maastricht Study

Journal

HYPERTENSION
Volume 73, Issue 4, Pages 803-811

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/HYPERTENSIONAHA.118.12305

Keywords

aging; blood pressure; executive function; memory; risk factor

Funding

  1. European Regional Development Fund via OP-Zuid
  2. Province of Limburg
  3. Dutch Ministry of Economic Affairs [31O.041]
  4. Stichting De Weijerhorst (Maastricht, the Netherlands)
  5. Pearl String Initiative Diabetes (Amsterdam, the Netherlands)
  6. Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases (Maastricht, the Netherlands)
  7. Stichting Annadal (Maastricht, the Netherlands)
  8. Health Foundation Limburg (Maastricht, the Netherlands)
  9. Janssen-Cilag B.V. (Tilburg, the Netherlands)
  10. Novo Nordisk Farma B.V. (Alphen aan den Rijn, the Netherlands)
  11. Sanofi-Aventis Netherlands B.V. (Gouda, the Netherlands)

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An increasing number of individuals will face age-related cognitive difficulties because life expectancy has increased. It is, therefore, important to identify modifiable risk factors for cognitive impairment. Very short-term to mid-term blood pressure variability (BPV) may be such a factor because it may cause cerebral ischemia. To this end, we investigated whether greater systolic and diastolic BPV are cross-sectionally associated with memory function (n=1804), information processing speed (n=1793), and executive function (n=1780) in 40- to 75-year-old individuals from The Maastricht Study. A composite BPV-index was derived by standardizing within-visit, 24-hour, and 7-day BPV. We performed linear regression with adjustments for age, sex, educational level, 24-hour systolic or diastolic pressure, and cardiovascular risk factors. We found that a 1-SD greater systolic BPV was not associated with information processing speed (beta [SD difference], -0.10; 95% CI, -0.14 to 0.06), or executive function (-0.09; 95% CI, -0.20 to 0.02) but was marginally associated with lower memory function (-0.11; 95% CI, -0.21 to 0.00). A 1-SD greater diastolic BPV was associated with lower information processing speed (-0.10; 95% CI, -0.20 to -0.00) and executive function (-0.12; 95% CI, -0.22 to -0.01) and marginally associated with lower memory function (-0.09; 95% CI, -0.20 to 0.01). These effects on cognitive performance are equivalent to approximate to 3 additional years of aging. In conclusion, greater very short-term to mid-term diastolic and, to a lesser extent, systolic BPV may be a modifiable risk factor for cognitive deterioration in 40- to 75-year-old, community-dwelling individuals.

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