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The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults

Xiaoyue Xu1,2, Vibeke S Catts3, Katie Harris2

  • 1School of Population Health, Faculty of Medicine and Health.

Journal of Hypertension
|July 11, 2024
PubMed

Insights

Long-term elevated blood pressure (BP) in older adults is linked to increased mortality. High cumulative pulse pressure (cPP) load predicts all-cause death, while high cumulative systolic BP (cSBP) load predicts cardiovascular death.

Area of Science:

  • Gerontology
  • Cardiovascular Health
  • Neurology

Background:

  • Limited research exists on the impact of sustained high blood pressure (BP) on dementia and mortality.
  • This study investigates the association between cumulative BP load and adverse health outcomes in older Australians.

Purpose of the Study:

  • To examine the relationship between cumulative BP load (systolic, diastolic, and pulse pressure) and the risk of dementia, cognitive decline, and all-cause and cardiovascular mortality.
  • To explore potential differences in these associations based on seated versus standing BP measurements.

Main Methods:

  • Utilized data from the Sydney Memory and Aging Study, including 1037 community-dwelling individuals aged 70-90 years.
  • Calculated cumulative BP load metrics (cSBP, cDBP, cPP) based on defined thresholds and area under the curve.
  • Employed Cox and mixed linear models to analyze associations over a mean follow-up of 10.5 years.

Main Results:

  • Higher cumulative pulse pressure (cPP) load was significantly associated with an increased risk of all-cause mortality.
  • Higher cumulative systolic blood pressure (cSBP) load was linked to a greater risk of cardiovascular deaths.
  • Associations between cPP load and dementia/cognitive decline were not statistically significant after age adjustment. No significant differences were found between seated and standing BP measurements.

Conclusions:

  • Long-term cumulative pulse pressure load is a predictor of all-cause mortality in older Australians.
  • Sustained high cumulative systolic blood pressure load is associated with an increased risk of cardiovascular mortality in this population.
Abstract

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