Related Experiment Video
Updated: Jun 4, 2025
Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients
Published on: December 16, 2022
Comparison of visit-to-visit blood pressure variability and time in target range in predicting risk for cognitive
Isabel J Sible1, Daniel A Nation2,3
1Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
Background:
Blood pressure (BP) variability (BPV) and time in target range (TTR) are emerging vascular risk factors for dementia, independent of traditionally targeted mean BP.
Objective:
Determine whether BPV or TTR is most strongly associated with cognitive risk.
Methods:
In this post hoc analysis of the SPRINT trial, 8034 participants underwent repeated BP measurement and cognitive testing at baseline and follow-up. Visit-to-visit BPV was calculated as average real variability. TTR was the percent of time in desired treatment arm target range (standard: 120-140 mmHg systolic BP; intensive: 110-130 mmHg systolic BP). Adjudicated clinical outcomes were no cognitive impairment, mild cognitive impairment (MCI), and probable dementia. We investigated a direct comparison of BPV and TTR in predicting cognitive risk, stratified by BP treatment group.
Results:
Elevated BPV was associated with increased risk for MCI (adjusted HR: 1.21 [95% CI 1.10, 1.33], p < 0.001) and MCI/dementia (HR: 1.17 [95% CI 1.07, 1.27], p < 0.001) in the standard group, and dementia (HR: 1.17 [95% CI 1.01, 1.36], p = 0.039) in the intensive group. Higher TTR was related to lower dementia risk (HR: 0.72 [95% CI 0.60, 0.86], p < 0.001) in the intensive group only.
Conclusions:
Visit-to-visit BPV outperformed TTR in predicting risk for MCI and MCI/dementia. TTR was more strongly associated with dementia risk under intensive treatment. Findings were independent of mean BP in a cohort with rigorously controlled BP and suggest newer aspects of BP control may be harnessed to further reduce cognitive risk.
Clinical Trial Information:
ClinicalTrials.gov; NCT01206062.
Related Concept Videos
01:23Assessment of blood pressure in brachial artery(two-step method)
01:10Pre-Procedural Guidelines for Assessing Blood Pressure
01:28Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
01:17Measurement of Blood Pressure
01:15Assessment of blood pressure in brachial artery(one-step method)
Prepare for the Procedure:
01:21Sites for measruring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement