What is the clinical evidence from this study?

Study design: Cohort. Population: Dementia (n=1270). Intervention: High systolic blood pressure (≥180 mm Hg) vs. Systolic blood pressure 141-160 mm Hg. Primary outcome: Incidence of dementia (RR 1.6).

November 20, 2001

Blood pressure and dementia in persons 75+ years old: 3-year follow-up results from the Kungsholmen Project

Key Result

Baseline systolic blood pressure ≥180 mm Hg was associated with an increased risk of incident dementia (RR 1.6) compared to systolic pressure of 141-160 mm Hg in adults aged 75 and older.

Study Design

Type

Cohort (n=1,270)

Structured PICO

Does high systolic blood pressure or blood pressure reduction influence the incidence of dementia in non-demented persons aged 75+ years?

Population

1,270 non-demented adults aged 75 years and older followed for an average of 3 years to evaluate the influence of blood pressure on dementia incidence.

Exposure

Baseline systolic blood pressure >= 180 mm Hg or decrease in blood pressure from baseline to follow-up

Comparator

Baseline systolic blood pressure of 141-160 mm Hg

Outcome

Incidence of dementiahard clinical

High systolic blood pressure is associated with an increased risk of dementia in older adults, while blood pressure reduction may be secondary to the dementia process itself.

Main Result

Relative Risk: 1.6

Abstract

A community cohort of 1270 non-demented 75+ years old persons was followed to evaluate the influence of blood pressure on incidence of dementia. Two hundred and eighteen dementia cases were detected during an average of three years of follow-up. Subjects with baseline systolic pressure >/= 180 mm Hg had an age- and gender-adjusted relative risk (RR) of 1.6 (95% to persons with systolic pressure of 141-160 mm Hg. This association persisted, although not statistically significant, when education, vascular diseases, and antihypertensive drug use were entered in the model (RR = 1.4; 95% systolic pressure were not related to dementia incidence. However, individuals with a decrease of 5--19 mm Hg and >/= 20 mm Hg in systolic pressure from baseline to follow-up had a RR of 1.8 (95% 2.6) and 2.5 (95% also found in subjects with diastolic pressure reduction. In conclusion, our findings support an association between high systolic pressure and increased risk of dementia, whereas blood pressure reduction may be secondary to the dementia process itself.

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