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Blood pressure, hypertension, and age as risk factors for poor cognitive performance
P K Elias1, R B D'Agostino, M F Elias
1Department of Mathematics, Boston University, MA 02215, USA.
Insights
High blood pressure and longer hypertension duration negatively impact cognitive function, particularly memory. Age also significantly impairs cognitive performance, with greater odds of decline than blood pressure metrics.
Area of Science:
- Epidemiology
- Neuroscience
- Cardiology
Background:
- Hypertension is a significant public health concern.
- Cognitive decline is a growing issue in aging populations.
- Understanding risk factors for cognitive impairment is crucial.
Purpose of the Study:
- To investigate the association between blood pressure variables and cognitive performance.
- To examine the relationship between hypertension chronicity and cognitive function.
- To compare the impact of blood pressure and age on cognition.
Main Methods:
- Analysis of data from 1,695 stroke-free Framingham Heart Study participants.
- Utilized multiple blood pressure measurements over 8-10 years.
- Employed logistic regression to assess cognitive performance on the Kaplan-Albert Neuropsychological Test Battery 12-14 years later.
Main Results:
- Elevated systolic and diastolic blood pressures were linked to poorer visual and verbal memory.
- Longer duration of hypertension correlated with decreased cognitive performance.
- Age demonstrated a stronger inverse association with all cognitive tests than blood pressure.
Conclusions:
- Hypertension and its chronicity are associated with cognitive deficits, particularly in memory.
- Age is a more potent predictor of cognitive decline than blood pressure.
- Findings highlight the public health importance of hypertension management for brain health.
Abstract:
The relationships of three blood pressure variables (systolic and diastolic pressures and chronicity of hypertension) and age to cognitive performance on the Kaplan-Albert Neuropsychological Test Battery were explored in a sample of 1,695 stroke-free participants of the Framingham Heart Study. Multiple blood pressure measurements were obtained over four or five exams extending over 8-10 years. Neuropsychological testing was conducted 12-14 years after the final blood pressure measurement. Data were subject to multiple binary logistic regression analyses, and odds ratios were calculated for performance in the lower 50th and 25th percentiles for 10-mmHg increases in diastolic blood pressure, 20-mmHg increases in systolic blood pressure, proportion of exams (out of four or five) in which participants were diagnosed as hypertensive, and 10-year increases in age. Blood pressures and chronicity of hypertension were inversely associated with performance on visual and verbal memory tests of the Kaplan-Albert battery. Age was inversely associated with performance on all tests in the battery. Generally, the odds of performing poorly were higher for age than for the blood pressure variables. The epidemiological significance of these findings is discussed in terms of implications for public health and management of hypertension.