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Correlation between blood pressure control status and cognitive impairment in older adults: A national
Junxiu Yao1, Shengshu Wang2, Meiling Li1
1Department of Cardiovascular Medicine, General Hospital of the Chinese People's Liberation Army Western Theater, Chengdu, China.
Insights
Blood pressure control impacts cognitive impairment in older adults. While intermediate blood pressure increased risk, well-controlled hypertension was linked to a reduced risk of cognitive decline.
Area of Science:
- Gerontology
- Neurology
- Cardiology
Background:
- Hypertension is a known risk factor for cognitive impairment.
- The specific relationship between blood pressure control levels and cognitive function in hypertensive older adults remains unclear.
Purpose of the Study:
- To investigate the association between different levels of blood pressure control and cognitive impairment in elderly individuals with hypertension.
- To identify specific blood pressure ranges associated with cognitive decline or preservation.
Main Methods:
- Cross-sectional analysis of 5,860 hypertensive participants from the 2018 Chinese Longitudinal Healthy Longevity Survey.
- Classification into hypotension, intermediate blood pressure, and hypertension groups based on blood pressure readings.
- Logistic regression and restricted cubic spline (RCS) models were employed to analyze the relationship between blood pressure control and cognitive impairment (defined as <18 on the Chinese Mini-Mental State Examination).
Main Results:
- The intermediate blood pressure group showed a significantly increased risk of cognitive impairment compared to the hypotension group.
- The hypertension group demonstrated a significantly reduced risk of cognitive impairment.
- No significant correlation was observed in individuals <80 years, with hearing impairment, or cerebrovascular diseases.
- In individuals aged ≥80 years, of Han ethnicity, or using antihypertensive drugs, hypotension was correlated with cognitive impairment, while hypertension was not.
- RCS analysis revealed a non-linear relationship between systolic blood pressure and cognitive impairment in those ≥80 years or on antihypertensive drugs, and a linear relationship with diastolic blood pressure.
Conclusions:
- Optimal blood pressure control in hypertensive individuals is associated with a lower risk of cognitive impairment.
- Hypotension, particularly in older adults, may pose a risk to cognitive function.
- The relationship between blood pressure and cognitive impairment is complex and varies by age and treatment status.
Abstract:
Hypertension is closely related to cognitive impairment; however, the correlation between blood pressure control and cognitive impairment in the hypertensive population is unclear. We aimed to explore the relationship between blood pressure control and cognitive impairment in older adults with hypertension. Using the cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey, 5,860 people with self-reported history of hypertension were divided into the hypotension, intermediate blood pressure, and hypertension groups. Cognitive impairment was defined as a score of < 18 on the Chinese version of the Mini-Mental State Examination. Demographics of the population were also collected. Bivariate Logistic regression analysis and restricted cubic spline (RCS) model were used to analyze the relationship between blood pressure control and cognitive impairment. After adjusting for confounding factors, binary logistic regression analysis showed that the intermediate group was significantly associated with an increased risk of cognitive impairment than the hypotension group, whereas the hypertension group was significantly correlated with a reduced risk of cognitive impairment. No significant correlation was found between blood pressure control and cognitive impairment in patients aged <80 years, with hearing impairment, or with cerebrovascular diseases, whether in the hypotension or hypertension groups. There was a significant correlation between hypotension and cognitive impairment, and no correlation between hypertension and cognitive impairment in people aged ≥ 80 years, Han ethnicity and those who used antihypertensive drugs. Furthermore, RCS model analysis showed that there was a non-linear relationship between systolic blood pressure and cognitive impairment in individuals aged ≥ 80 years and those using antihypertensive drugs. There was a linear relationship between diastolic blood pressure and cognitive impairment. Blood pressure control in the hypertensive group was significantly associated with a lower risk of cognitive impairment.
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