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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

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Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts

Yanjun Ma1,2,3, Rong Hua1,2, Zhenchun Yang4

  • 1Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.

BMC Medicine
|November 2, 2021
PubMed

Insights

Individuals with borderline blood pressure (BP) between 130/80 and 140/90 mmHg did not show increased cognitive decline. This suggests that antihypertension therapy may not be necessary for this group, considering cognitive health.

Area of Science:

  • Gerontology
  • Cardiology
  • Neurology

Background:

  • Conflicting definitions of hypertension exist: 2017 ACC/AHA guidelines define it as ≥130/80 mmHg, while 2018 ESC/ESH guidelines use ≥140/90 mmHg.
  • This discrepancy impacts clinical decisions regarding blood pressure management.

Purpose of the Study:

  • To compare cognitive decline trajectories in adults based on differing blood pressure (BP) thresholds.
  • To investigate the impact of borderline BP (130/80-140/90 mmHg) on cognitive function compared to normal BP (<130/80 mmHg).

Main Methods:

  • Pooled analysis of three large, nationally representative cohorts: Health and Retirement Study (HRS), English Longitudinal Study of Ageing (ELSA), and China Health Retirement Longitudinal Study (CHARLS).
  • Participants were categorized into Normal (BP <130/80 mmHg), Borderline (BP <140/90 mmHg but not Normal), and High BP groups.
  • Global cognitive function was assessed using memory, executive function, and orientation tests, with a global cognitive Z-score calculated.

Main Results:

  • No significant difference in the rate of global cognitive decline was observed between the Normal and Borderline BP groups for both men and women.
  • Participants in the High BP group exhibited a significantly faster rate of cognitive decline compared to the Borderline BP group.
  • The study included 17,590 participants with median follow-up periods ranging from 7 to 16 years.

Conclusions:

  • Borderline blood pressure levels (130/80-140/90 mmHg) are not associated with a significantly faster rate of cognitive decline compared to normal levels.
  • Initiating antihypertension therapy for individuals with borderline BP may not be necessary solely based on concerns about cognitive decline.
Abstract

Keywords:
Blood pressureCognitive dysfunctionHypertension

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