Larger visit-to-visit systolic blood pressure variability was associated with cognitive deterioration (OR 2.64; 95% CI 2.29-3.04; p<0.001) and a higher burden of vascular and Alzheimer pathology.
Cohort (n=13,284)
Yes
Does larger visit-to-visit systolic blood pressure variability increase the risk of cognitive deterioration and neuropathology in dementia-free adults ≥50 years of age?
Larger visit-to-visit systolic blood pressure variability is significantly associated with cognitive deterioration and an increased burden of cerebrovascular and Alzheimer's disease neuropathology.
Odds Ratio: 2.64 (95% CI 2.29–3.04)
p-value: p=<0.001
Objective Large systolic blood pressure (SBP) variability has been proposed as a novel risk factor for dementia above and beyond SBP levels, but the underlying neuropathology is largely unknown. We investigated the relationship among visit-to-visit SBP variability, cognitive deterioration, and underlying neuropathologic changes. Methods We used longitudinal data (between 2005 and 2019) from the National Alzheimer9s Coordinating Center. A total of 13,284 dementia-free participants ≥50 years of age were followed up over a median of 5.0 (interquartile range 3.1–7.6) years. Neuropathology data were available in 1,400 autopsied participants. Visit-to-visit SBP variability was quantified from repeated annual SBP measurements. Cognitive deterioration was defined as conversion from normal cognition to mild cognitive impairment (MCI) or dementia or from MCI to dementia. Results Larger visit-to-visit SBP variability was associated with cognitive deterioration (adjusted odds ratio comparing extreme quintiles 2.64, 95% confidence interval 2.29–3.04, p p Conclusion Larger visit-to-visit SBP variability was associated with cognitive deterioration. It was also associated with cerebrovascular pathology and neurofibrillary tangles. These results suggest the intertwined role of vascular and Alzheimer disease pathology in the etiology of dementia.
Ma et al. (Tue,) conducted a cohort in Cognitive decline (n=13,284). Visit-to-visit systolic blood pressure variability vs. Lowest quintile of systolic blood pressure variability was evaluated on Cognitive deterioration (conversion from normal cognition to mild cognitive impairment or dementia, or from MCI to dementia) (OR 2.64, 95% CI 2.29-3.04, p=<0.001). Larger visit-to-visit systolic blood pressure variability was associated with cognitive deterioration (OR 2.64; 95% CI 2.29-3.04; p<0.001) and a higher burden of vascular and Alzheimer pathology.
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