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The relationship between temporal changes in blood pressure and changes in cognitive function: atherosclerosis risk
Suzana Alves de Moraes1, Moyses Szklo, David Knopman
1Department of Epidemiology, School of Hygiene and Public Health, The Johns Hoipkins University, 615 N Wolfe Street, Room W6009, Baltimore, MD 21205, USA. smoraes@jhsph.edu
Insights
Hypertension significantly impacts cognitive decline, especially in older adults. Uncontrolled high blood pressure over six years was linked to worse cognitive function, highlighting the importance of blood pressure management for brain health.
Area of Science:
- Neurology
- Epidemiology
- Gerontology
Background:
- Hypertension is a known risk factor for reduced brain perfusion and atrophy.
- Previous studies link these to cognitive decline.
- The effect of changing blood pressure over time on age-related cognitive decline remains understudied.
Purpose of the Study:
- To assess the impact of temporal changes in blood pressure on cognitive decline.
- To evaluate changes in hypertension status and cognitive function over a 6-year period.
Main Methods:
- Analysis of 8,058 participants (aged 48-67) from the Atherosclerosis Risk in Communities (ARIC) Study.
- Measured changes in hypertension status and cognitive function (Delayed Word Recall, Digit Symbol Subtest, Word Fluency) between two visits.
- Used linear regression to compare cognitive function across hypertension categories.
Main Results:
- Uncontrolled hypertension was associated with a significantly larger decline in Digit Symbol Subtest scores compared to normotensive individuals.
- Partially or uncontrolled hypertension showed a trend towards less favorable cognitive profiles, particularly in Digit Symbol and Word Fluency tests.
- While not all cognitive declines reached statistical significance, the findings suggest an association between hypertension status changes and cognitive changes.
Conclusions:
- Changes in hypertension status over a 6-year period are related to cognitive changes in middle-aged and older adults.
- These findings support the hypothesis linking hypertension management to cognitive health preservation.
- Further research is warranted to explore the nuances of blood pressure variability and cognitive trajectories.
Background:
Although previous epidemiological studies have reported that hypertension is a major risk factor for decline in brain perfusion and atrophy, which are known to be related to cognitive decline, the impact of temporal changes in blood pressure on age-related cognitive declines has not been assessed.
Methods:
The present study evaluates changes in blood pressure and cognitive decline over a 6-year period in the Atherosclerosis Risk in Communities (ARIC) Study. This report is based on 8,058 men and women aged 48-67 years examined in the second (1990-92), and fourth (1996-98) ARIC cohort visits. Changes between these visits were measured in hypertension status and three cognitive function tests: Delayed Word Recall (DWR), the Digit Symbol Subtest of the Wechsler Adult Intelligence Scale-Revised (DSS/WAIS-R), and the Word Fluency (WF). Adjusted mean differences in cognitive function were compared among five categories of hypertension status by using linear regression modeling.
Results:
In the present study, older subjects with uncontrolled hypertension had a significantly larger mean DSS/WAIS-R score decline than normotensive subjects. Although other cognitive declines did not achieve statistical significance, both cross-sectional and change analysis suggested that partially controlled or uncontrolled hypertension is associated with a less favorable cognitive profile, particularly when considering results of the DSS and the WF tests.
Conclusions:
The present study results provide some support to the hypothesis that hypertension status changes over 6 years in individuals initially aged 48-67 years are related to cognitive changes.
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