Key result
The combination of highest tertile NT-proBNP and lowest tertile systolic blood pressure was associated with a 0.49-point-steeper annual decline in MMSE score compared to other categories (p<0.001).
Why the study?
Are high NT-proBNP levels and low systolic blood pressure associated with cognitive decline in the oldest old?
Cohort (n=560)
Are high NT-proBNP levels and low systolic blood pressure associated with cognitive decline in the oldest old?
Mean Difference: -0.49
p-value: p=<0.001
In 85-year-olds, the combination of elevated NT-proBNP and low systolic blood pressure is strongly associated with worse baseline cognitive function and steeper cognitive decline, suggesting a link between failing cardiac pump function and brain dysfunction.
NT-proBNP may flag cognitive vulnerability in those ≥85; leaves open utility for risk stratification or intervention.
OBJECTIVE: To study the relation between N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, used as a marker of heart failure in clinical practice, blood pressure (BP), and cognitive decline in the oldest old. METHODS: In 560 participants of the Leiden 85-plus Study, we measured NT-proBNP levels and BP at age 85 years, at baseline, and global cognitive function (Mini-Mental State Examination [MMSE]) annually during the follow-up of 5 years. RESULTS: Subjects in the highest tertile of NT-proBNP levels scored 1.7 points lower on the MMSE at age 85 years than subjects in the lowest tertile (p = 0.004), and had a 0.24-point-steeper decline in MMSE score per year (p = 0.021). The longitudinal association disappeared after full adjustment for possible confounders (0.14-point-steeper decline, p = 0.187). Subjects in the category "highest tertile of NT-proBNP and the lowest tertile of systolic BP" had a 3.7-point-lower MMSE score at baseline (p < 0.001) and a 0.49-point-steeper decline in MMSE score per year (p < 0.001) compared with subjects in the other categories. CONCLUSIONS: In the oldest old, high NT-proBNP levels are associated with lower MMSE scores. The combination of high NT-proBNP levels and low systolic BP is associated with worst global cognitive function and the steepest cognitive decline. Possibly, a failing pump function of the heart results in lower BP and lower brain perfusion with resultant brain dysfunction.
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Vliet et al. (2014) conducted a cohort in Cognitive decline (n=560). Highest tertile of NT-proBNP and lowest tertile of systolic blood pressure vs. Other categories was evaluated on Decline in Mini-Mental State Examination (MMSE) score per year (0.49-point-steeper decline, p=<0.001). The combination of highest tertile NT-proBNP and lowest tertile systolic blood pressure was associated with a 0.49-point-steeper annual decline in MMSE score compared to other categories (p<0.001).
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