In older adults with hypertension, a 1% increase in short-term blood pressure variability was associated with a 1.7-fold increased risk of having an MMSE below 24 (95% CI 1.0-2.7; p=0.03647).
Cross-Sectional (n=278)
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Is short-term blood pressure variability associated with physical and cognitive frailty in older adults with arterial hypertension?
In older adults with hypertension, short-term blood pressure variability is correlated with overall frailty and worse cognitive performance.
Relative Risk: 1.7 (95% CI 1–2.7)
valor p: p=0.03647
Objective: We aimed to characterize ambulatory BP monitoring (ABPM)-assessed short term blood pressure (BP) variability in older adults with hypertension. Design and method: We analyzed cross-sectional data from the Italian multicentric longitudinal HYPER-FRAIL study. Individuals >= 75 years and suffering from arterial hypertension underwent a comprehensive geriatric assessment, measurement of office, home and ABPM BP. Short-term BP variability was defined as the standard deviation of the daily systolic BP divided by the daily systolic BP mean (dCV). Results: In the study cohort (n=278 patients of 81±4 years, 58% women), we observed a positive correlation between dCV and age (p=0.0013), social support score (p=0.0020), Fried frailty phenotype (p=0.0306), frailty index (p=0.0234), clinical frailty scale (CFS; p=0.0271), and a negative correlation with iADL (p=0.0039), number of anti-hypertensive drugs (p=0.0063). dCV was higher in patients with a miniCog test impaired (p=0.0256). In fit-to-mild frail subjects (CFS <= 5) the positive correlation with social support scale (p=0.0031) and the negative correlation with iADL (p=0.0237) and number of anti-hypertensive drugs (p=0.0183) were confirmed. In fit-to-mild frail subjects on BP target according to ESH guidelines and without orthostatic hypotension, all these correlations were lost. In these individuals dCV was negatively correlated with Mini Mental State Examination (MMSE; p=0.0140) and higher in subjects with a positive miniCog (p=0.0484). If stratified for the median value (12%), subjects with higher dCV had lower MMSE (23 vs 28, p=0.01048); 1% increase in dCV was associated with an increased risk of 1.7 (95% CI 1.0-2.7, p=0.03647) of having a MMSE below 24. Conclusions: In older adults with hypertension dCV seems correlated with overall frailty. However, in non-moderate/severe frail subjects on BP target, it identifies a phenotype associated with worse cognitive performance.
Pardini et al. (Fri,) conducted a cross-sectional in arterial hypertension (n=278). Short-term blood pressure variability (dCV) vs. Lower short-term blood pressure variability was evaluated on MMSE below 24 (RR 1.7, 95% CI 1.0-2.7, p=0.03647). In older adults with hypertension, a 1% increase in short-term blood pressure variability was associated with a 1.7-fold increased risk of having an MMSE below 24 (95% CI 1.0-2.7; p=0.03647).