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The relationship between blood pressure and cognitive decline differs by race
Michael D Oliver1, Cassandra Morrison2, Sondos El-Hulu1
1Department of Psychological Science and Neuroscience, Belmont University, Nashville, Tennessee, United States.
The Gerontologist
|September 10, 2025
Summary
Blood pressure variations impact cognitive decline differently in Black and White older adults. White adults with high or variable blood pressure showed faster cognitive decline than Black adults.
Area of Science:
- Neuroscience
- Gerontology
- Public Health
Background:
- Blood pressure (BP) is a known factor influencing cognitive function.
- Existing research suggests potential racial disparities in how BP affects cognition.
Purpose of the Study:
- To investigate the relationship between blood pressure patterns and cognitive decline in older Black and White adults.
- To examine racial differences in the impact of normal, high, and variable blood pressure on cognitive trajectories.
Main Methods:
- Analysis of 2,284 older adults (Black and White) from three harmonized cohorts.
- Participants categorized into normal, high, or variable systolic blood pressure groups.
- Cognitive function assessed across five domains and global cognition over an average of 6.7 years using linear mixed-effects models.
Main Results:
- White adults with high or variable blood pressure exhibited faster cognitive decline across multiple domains compared to Black adults.
- Specifically, White adults with variable blood pressure showed accelerated decline in global cognition and all tested cognitive domains.
- No significant differences in cognitive decline rates were observed between Black and White older adults with normal blood pressure.
Conclusions:
- Blood pressure variations have differential effects on cognitive decline in older Black and White populations.
- Race is a critical factor in understanding the complex interplay between blood pressure and cognitive health.
- These findings underscore the need for race-conscious approaches in managing blood pressure to preserve cognitive function in aging adults.
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