Dose-Response Relationship Between Long-Term Blood Pressure Variability and Cognitive Decline

Area of Science:

• Gerontology
• Neuroscience
• Cardiovascular Medicine

Background:

• Long-term blood pressure variability (BPV) is a potential risk factor for cognitive decline.
• Understanding the relationship between BPV and cognitive function is crucial for aging populations.

Purpose of the Study:

• To investigate the association between long-term blood pressure variability and the rate of cognitive decline.
• To explore a potential dose-response relationship between blood pressure variability and cognitive decline.

Main Methods:

• Utilized data from the Health and Retirement Study and the English Longitudinal Study of Ageing.
• Assessed cognitive function using standardized Z scores and measured blood pressure variability via SD, coefficient of variation, and variation independent of mean.
• Employed linear mixed models, restricted splines, and segmented regression for association and dose-response analyses, supplemented by meta-analysis.

Main Results:

• Included 12,298 dementia-free participants (mean age 64.6 years).
• Found a significant association between higher blood pressure variability and accelerated global cognitive decline.
• Each 10% increase in systolic and diastolic blood pressure variability correlated with a 0.026 and 0.022 SD/year decline, respectively, with a nonlinear dose-response pattern.

Conclusions:

• Elevated long-term blood pressure variability is associated with accelerated cognitive decline in adults aged 50 and older.
• A nonlinear dose-response relationship was identified, indicating that higher variability poses greater risk.
• Further research, including randomized controlled trials, is recommended to assess the cognitive benefits of blood pressure variability-lowering strategies.