Association between blood pressure and cognitive function in a biracial community population of older persons

We examined whether or not blood pressure is related to cognitive function in a cross-sectional study of a biracial community of 5,816 persons aged 65 years and older. Blood pressure had a curvilinear association with cognitive performance in linear regression models adjusted for age, sex, race and education. Scores were lower by 2-5 percentiles at 100 mm Hg systolic pressure compared to scores at the mean of 140 mm Hg and lower by <1 percentile at 180 mm Hg. For diastolic pressure, scores were lower by 2-3 percentiles at 60 mm Hg and by 1-2 percentiles at 100 mm Hg compared to scores at the mean (77 mm Hg). The differences in the scores with low blood pressure were reduced with further adjustment for body mass index, self-perceived health status, depressive symptoms, alcohol use and smoking. The curvilinear associations were stronger among persons with histories of stroke, myocardial infarction and hypertension. The cross-sectional association between blood pressure and cognitive functions is small and curvilinear and more apparent in persons with cardiovascular conditions.