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Systolic blood pressure within an intermediate range may reduce memory loss in an elderly hypertensive cohort

N Sacktor1, S Gray, C Kawas

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Insights

Maintaining systolic blood pressure (BP) too high or too low in treated hypertensive patients may increase memory decline risk. Optimal BP regulation is key for cognitive health in older adults.

Area of Science:

  • Neurology
  • Gerontology
  • Cardiology

Background:

  • Hypertension is a prevalent condition in older adults.
  • The impact of systolic blood pressure (BP) control on cognitive function in treated hypertensive patients remains an area of investigation.
  • Memory decline is a significant concern for the aging population.

Purpose of the Study:

  • To investigate the association between different systolic blood pressure (BP) ranges and memory decline in treated hypertensive patients.
  • To determine if maintaining high or low systolic BP levels increases the risk of cognitive decline.

Main Methods:

  • A cohort of 158 treated hypertensive subjects underwent biennial neuropsychological evaluations.
  • Memory decline was assessed annually using the Cued Selective Reminding test (total free recall and delayed recall).
  • Subjects were categorized into three systolic BP groups: low (<135 mm Hg), intermediate (135-150 mm Hg), and high (>150 mm Hg).

Main Results:

  • Patients in the high systolic BP group (>150 mm Hg) exhibited the greatest decline in total free recall.
  • Patients in the low systolic BP group (<135 mm Hg) showed the greatest decline in delayed recall.
  • Significant differences in annual memory decline were observed across the three systolic BP groups for both total free recall (P=.02) and delayed recall (P=.04).

Conclusions:

  • Chronically elevated systolic BP (>150 mm Hg) is linked to accelerated memory decline in treated hypertensive patients.
  • Sustained low systolic BP (<135 mm Hg) may also be associated with accelerated memory decline, particularly in delayed recall.
  • Optimizing systolic blood pressure (BP) control may serve as a modifiable risk factor to mitigate memory loss in older hypertensive individuals.

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