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Updated: Jun 22, 2025

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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Long-Term Visit-to-Visit Blood Pressure Variability and Cognitive Decline Among Patients With Hypertension: A Pooled

Guangjun Zheng1, Biying Zhou1, Zhenger Fang1

  • 1Department of Public Health and Preventive Medicine, School of Medicine Jinan University Guangzhou China.

Journal of the American Heart Association
|June 27, 2024
PubMed

Insights

High blood pressure variability (BPV) is linked to faster cognitive decline in hypertensive patients. This association persists even with medication or controlled blood pressure, suggesting BPV as a key factor in cognitive health.

Area of Science:

  • Cardiology
  • Neurology
  • Gerontology

Background:

  • Limited research exists on blood pressure variability (BPV) and cognitive impairment in hypertensive individuals.
  • This study addresses the longitudinal association between BPV and cognitive decline, considering the impact of blood pressure (BP) control.

Purpose of the Study:

  • To investigate the longitudinal association between blood pressure variability (BPV) and cognitive decline in patients with hypertension.
  • To determine the role of blood pressure (BP) control in the relationship between BPV and cognitive decline.

Main Methods:

  • Utilized data from the Health and Retirement Study (HRS), English Longitudinal Study of Ageing (ELSA), and China Health and Retirement Longitudinal Study (CHARLS).
  • Measured BPV using Variation Independent of the Mean (VIM).
  • Assessed cognitive function via standard questionnaires, calculating a standardized Z-score. Employed linear mixed-model and restricted cubic splines for analysis.

Main Results:

  • Included 4853 (HRS), 1616 (ELSA), and 1432 (CHARLS) hypertensive patients.
  • Each standard deviation (SD) increment in VIM for systolic BP (pooled β, -0.045) and diastolic BP (pooled β, -0.022) was significantly associated with global cognitive function decline.
  • These associations were consistent in patients on antihypertensive drugs and those with well-controlled BP.

Conclusions:

  • Elevated BPV is independently associated with accelerated cognitive decline in hypertensive patients.
  • This link is evident irrespective of antihypertensive medication use or BP control status.
  • Further research is warranted to validate these findings and explore BPV reduction as a strategy for cognitive health.
Abstract

Keywords:
blood pressure variabilitycognitive declinepooled analysis

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