Key result
Higher awake systolic BP variability is linked to worse cognitive performance in older adults.
Why the study?
High blood pressure variability in older age appears to be an independent risk factor for incident dementia, but its relationships with cognitive functioning and vascular stiffness are not fully understood.
Does higher blood pressure variability reduce cognitive functioning and increase vascular stiffness in older adults?
Cross-Sectional (n=70)
No
Does higher blood pressure variability reduce cognitive functioning and increase vascular stiffness in older adults?
Effect estimate: β = -0.41 (95% CI -0.87, -0.23)
p-value: p=0.001
Short- and mid-term blood pressure variability may serve as early clinical markers for cognitive decline and arterial stiffness in older adults independently of mean blood pressure.
Background: High blood pressure variability (BPV), particularly in older age, appears to be an independent risk factor for incident dementia. The current study aimed to investigate the association between different BPV measures (short- and mid-term BPV including circadian patterns) and cognitive functioning as well as vascular stiffness measures to better understand the role that BPV plays in cognitive impairment. Methods: 70 older adults (60-80-year-olds) without dementia completed a cognitive test battery and had their blood pressure (BP) assessed via a 24-hour ambulatory BP monitor (divided into sleep and wake for short-term BPV) and 4-day morning and evening home-based BP monitor (for day-to-day BPV). Arterial stiffness was evaluated via pulse wave analysis and pulse wave velocity (PWV) and cerebrovascular pulsatility was assessed via transcranial doppler sonography of the middle cerebral arteries. Results: High systolic as well as diastolic short- and mid-term BPV were associated with poorer cognitive functioning, independent of the mean BP. Higher short-term BPV was associated with poorer attention and psychomotor speed, whilst day-to-day BPV was negatively linked with executive functioning. Circadian BP patterns (dipping and morning BP surge) showed no significant relationships with cognition after adjusting for covariates. Higher systolic short-term BPV was associated with higher arterial stiffness (PWV) and higher diastolic day-to-day BPV was linked with lower arterial stiffness. No significant associations between BPV measures and cerebrovascular pulsatility were present. Conclusion: High BPV, independently of the mean BP, is associated with lower cognitive performance and increased arterial stiffness in older adults without clinically-relevant cognitive impairment. This highlights the role of systolic and diastolic BPV as a potential early clinical marker for cognitive impairment.
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Gutteridge et al. (2023) conducted a cross-sectional in Cognitive performance and vascular stiffness in relation to blood pressure variability (n=70). High short- and mid-term blood pressure variability was evaluated on Overall cognitive performance (Modified Mini-Mental State Examination score) (β = -0.41, 95% CI -0.87, -0.23, p=0.001). Higher systolic awake short-term blood pressure variability was independently associated with reduced overall cognition (β = -0.41, p=0.001) in older adults.
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