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Blood pressure levels before dementia.

Diana B Petitti1, Valerie C Crooks, J Galen Buckwalter

  • 1Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, Pasadena, CA 91101, USA.

Archives of Neurology
|January 12, 2005
PubMed
Summary

Blood pressure (BP) decline, particularly diastolic BP, may precede dementia development. This study examined BP trends over 10 years in relation to cognitive status, finding significant declines in women who developed dementia.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Epidemiology

Background:

  • The relationship between blood pressure (BP) and dementia is complex and not fully understood.
  • Some research suggests that dementia may precede and influence BP levels.

Purpose of the Study:

  • To investigate the longitudinal association between blood pressure (BP) over a 10-year period and the prevalence of dementia.
  • To compare BP trajectories in individuals with and without cognitive impairment.

Main Methods:

  • A retrospective review of BP measurements from 965 participants in a health plan over 10 years prior to cognitive classification.
  • Participants were categorized into three groups: dementia (n=300), cognitive impairment (n=285), and unimpaired (n=585).
  • Longitudinal BP data (systolic and diastolic) were analyzed in relation to cognitive status.

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Main Results:

  • Systolic BP increased over time in unimpaired individuals, with a blunted increase in women who developed cognitive impairment or dementia.
  • Diastolic BP significantly declined over time across all groups (P<.001).
  • Women who developed dementia exhibited a significantly greater adjusted rate of diastolic BP decline compared to unimpaired women (P = .04).

Conclusions:

  • The findings support the hypothesis that declining blood pressure, especially diastolic BP, may be a precursor to dementia.
  • The complex association between BP and dementia is influenced by factors such as age at data collection.
  • Future research should prioritize prospective data collection with participants free of cognitive impairment at enrollment for valid inferences.