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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Blood pressure variability and cognitive dysfunction: A systematic review and meta-analysis of longitudinal cohort

Tzu-Jung Chiu1, Jiunn-Tyng Yeh1, Chi-Jung Huang2

  • 1Department of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan.

Journal of Clinical Hypertension (Greenwich, Conn.)
|June 21, 2021
PubMed

Insights

Higher blood pressure variability (BPV) is linked to an increased risk of dementia diagnosis, particularly in older adults. However, this association was not found for cognitive decline on standard tests.

Area of Science:

  • Neurology
  • Cardiology
  • Epidemiology

Background:

  • Blood pressure variability (BPV) is increasingly recognized for its potential role in cognitive health.
  • Previous clinical studies on BPV and cognitive dysfunction have yielded inconsistent results.
  • Understanding the precise relationship between BPV and cognitive decline or dementia is crucial for clinical practice.

Purpose of the Study:

  • To systematically investigate the association between blood pressure variability (BPV) and the risk of cognitive decline or dementia.
  • To synthesize findings from longitudinal cohort studies using meta-analysis techniques.
  • To explore potential moderating factors such as BPV measurement methods and participant demographics.

Main Methods:

  • A systematic literature search was conducted across PubMed, Scopus, and Embase.
  • Longitudinal cohort studies incorporating BPV measurements and neuropsychological assessments or dementia diagnoses were included.
  • Both traditional and dose-response meta-analyses were performed, including subgroup analyses.
  • Data from 20 cohort studies involving 7,924,168 individuals were analyzed.

Main Results:

  • Elevated systolic blood pressure variability (SBPV), measured by SBP-CV or SBP-SD, was associated with an increased risk of all-cause dementia diagnosis.
  • No significant association was observed between SBPV and the incidence of cognitive decline as assessed by neuropsychological examinations.
  • The association between SBPV and dementia risk was more pronounced with shorter BPV timeframes, shorter follow-up periods, and in individuals over 65 years.
  • A dose-response relationship between SBPV and dementia risk could not be established.

Conclusions:

  • This meta-analysis suggests a potential positive association between systolic blood pressure variability and the risk of dementia.
  • The findings highlight the importance of considering BPV in the context of dementia risk assessment, especially in the elderly.
  • Further research is warranted to confirm these associations and elucidate the underlying mechanisms.

Keywords:
blood pressure variabilitycognitive dysfunctioncohort studiesdementiameta-analysis

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