24-Hour Blood Pressure Variability Via Ambulatory Monitoring and Risk for Probable Dementia in the SPRINT Trial

Area of Science:

• Cardiovascular Health
• Neurology
• Geriatrics

Background:

• Blood pressure variability (BPV) is an emerging dementia risk factor, independent of mean blood pressure.
• Previous studies linked long-term BPV to dementia risk.
• Short-term BPV effects on cognition remained under-investigated.

Purpose of the Study:

• To examine the impact of ambulatory blood pressure variability on cognitive outcomes.
• To compare these effects between intensive and standard blood pressure lowering strategies.

Main Methods:

• Post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) involving 793 participants.
• 24-hour ambulatory blood pressure monitoring 27 months post-randomization.
• Cognitive testing and analysis of BPV (24-hour, daytime, nighttime) in relation to dementia risk.

Main Results:

• Higher 24-hour systolic BPV correlated with increased dementia risk in the standard BP group (HR: 2.56).
• This association was not significant in the intensive BP group (HR: 0.54).
• Daytime systolic BPV showed similar trends; nighttime BPV did not.

Conclusions:

• Elevated 24-hour and daytime systolic BPV are linked to dementia risk under standard BP treatment.
• Findings suggest BPV is a dementia risk even with controlled mean blood pressure.
• Intensive BP lowering might attenuate the dementia risk associated with BPV.