Abstract
Background
Hypertension is an important risk factor for cardiovascular diseases and cognitive function. Blood pressure (BP) variability has been associated with cognitive dysfunction, but data are sparse regarding the relationship between BP variability and cognitive function in geriatric patients with well-controlled BP.
Aim
The aim of this study was to demonstrate the relationship between blood pressure variability and cognitive functions in geriatric hypertensive patients with well-controlled BP.
Method
We analyzed 435 hypertensive patients (167 male, 74.9 ± 8.3; 268 female, 76.1 ± 8.6) treated at least with one antihypertensive drug. All patients underwent ambulatory BP monitoring and the standardized mini mental test (sMMT).
Results
We divided the weighted standard deviation (SD) of systolic BP (SBP) as a measure of BP variability into quartiles. The top quartile group (≥ 18.5 mmHg) had a significantly lower total sMMT score (23.3 ± 3.2, p < 0.001). According to the results of multivariate logistic regression analysis for sMMT, the SD of 24-h SBP was related to sMMT (p = 0.007, 95% confidence interval − 0.301 [− 0.370 to − 0.049]).
Discussion
Although there are some inconsistencies among the studies investigating the relationship between blood pressure variability and cognitive functions in elderly patients, we demonstrated the relationship between increased 24-h blood pressure variability and cognitive functions assessed with sMMT in geriatric population with well-controlled BP.
Conclusion
The increased blood pressure variability was associated with poorer cognitive functions in geriatric hypertensive patients with well-controlled blood pressure.
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References
Aronow WS, Fleg JL, Pepine CJ et al (2011) ACCF/AHA 2011 expert consensus document on hypertension in the elderly: a report of the American college of cardiology foundation task force on clinical expert consensus documents. Circulation 123:2434–2506
Clement DL, De Buyzere ML, De Bacquer DA et al (2003) Office versus Ambulatory Pressure Study Investigators. Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. N Engl J Med 348:2407–2415
Puisieux F, Monaca P, Deplanque D et al (2001) Relationship between leukoaraiosis and blood pressure variability in the elderly. Eur Neurol 46:115–120
Goldstein IB, Bartzokis G, Guthrie D et al (2005) Ambulatory blood pressure and the brain: a 5-year follow-up. Neurology 64:1846–1852
Gomez-Angelats E, De La Sierra A, Sierra C et al (2004) Blood pressure variability and silent cerebral damage in essential hypertension. Am J Hypertens 17:696–700
Bellelli G, Pezzini A, Bianchetti A et al (2002) Increased blood pressure variability may be associated with cognitive decline in hypertensive elderly subjects with no dementia. Arch Intern Med 62:483–484
Conway KS, Forbang N, Beben T et al (2015) Relationship between 24-hour ambulatory blood pressure and cognitive function in community-living older adults: the UCSD Ambulatory Blood Pressure Study. Am J Hypertens 28:1444–1452
Kanemaru A, Kanemaru K, Kuwajima I (2001) The effects of short-term blood pressure variability and nighttime blood pressure levels on cognitive function. Hypertens Res 24:19–24
Sakakura K, Ishikawa J, Okuno M et al (2007) Exaggerated ambulatory blood pressure variability is associated with cognitive dysfunction in the very elderly and quality of life in the younger elderly. Am J Hypertens 20:720–727
Yamaguchi Y, Wada M, Sato H et al (2014) Impact of ambulatory blood pressure variability on cerebral small vessel disease progression and cognitive decline in community-based elderly Japanese. Am J Hypertens 27:1257–1267
Iadecola C, Yaffe K, Biller J et al (2016) American Heart Association Council on Hypertension; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council. Impact of hypertension on cognitive function: a scientific statement from the American Heart Association. Hypertension 68:e67–e94
Cho N, Hoshide S, Nishizawa M et al (2018) Relationship between blood pressure variability and cognitive function in elderly patients with good blood pressure control. Am J Hypertens 31:293–298. https://doi.org/10.1093/ajh/hpx155
O’Brien E, Coats A, Owens P et al (2000) Use and interpretation of ambulatory blood pressure monitoring: recommendations of the British hypertension society. BMJ 320:1128–1134
Bilo G, Giglio A, Styczkiewicz K et al (2007) A new method for assessing 24-h blood pressure variability after excluding the contribution of nocturnal blood pressure fall. J Hypertens 25:2058–2066
Sakakura K, Ishikawa J, Okuno M et al (2007) Exaggerated ambulatory blood pressure variability is associated with cognitive dysfunction in the very elderly and quality of life in the younger elderly. Am J Hypertens 20:720–727
Kario K, Eguchi K, Hoshide S et al (2002) U-curve relationship between orthostatic blood pressure change and silent cerebrovascular disease in elderly hypertensives: orthostatic hypertension as a new cardiovascular risk factor. J Am Coll Cardiol 40:133–141
Waldstein SR, Siegel EL, Lefkowitz D et al (2004) Stress-induced blood pressure reactivity and silent cerebrovascular disease. Stroke 35:1294 – 1298
Zhao JH, Tian XJ, Liu YX et al (2013) Executive dysfunction in patients with cerebral hypoperfusion after cerebral angiostenosis/occlusion. Neurol Med Chir (Tokyo) 53:141–147
Volicer L, Harper DG, Manning BC et al (2001) Sundowning and circadian rhythms in Alzheimer’s disease. Am J Psychiatry 158:704 – 711
Beauchet O, Herrmann FR, Annweiler C et al (2010) Association between ambulatory 24-hour blood pressure levels and cognitive performance: a cross-sectional elderly population-based study. Rejuvenation Res 13:39–46
Cacciatore F, Abete P, de Santis D et al (2005) Mortality and blood pressure in elderly people with and without cognitive impairment. Gerontology 51:53–61
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The protocol for sample collection was approved by the Biruni University, Medical Faculty Ethics Committee and was carried out according to the requirements of the Second Declaration of Helsinki. This article does not contain any studies with animals performed by any of the authors.
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Yıldırım, E., Ermis, E., Allahverdiyev, S. et al. Relationship between blood pressure variability and cognitive function in geriatric hypertensive patients with well-controlled blood pressure. Aging Clin Exp Res 32, 93–98 (2020). https://doi.org/10.1007/s40520-019-01141-6
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DOI: https://doi.org/10.1007/s40520-019-01141-6