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American Heart Association, Hypertension, 4(73), p. 803-811, 2019

DOI: 10.1161/hypertensionaha.118.12305

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Greater Blood Pressure Variability Is Associated With Lower Cognitive Performance

This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

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 (β [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 ≈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.