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Elevated blood pressure associated with cognitive decline in elderly

Cognitive decline, dementia, and mortality can be reduced by blood pressure control


Key points from article :

Blood pressure associated with cognitive decline, dementia, and mortality- research by Dr. Wuxiang Xie and colleagues.

Two cohorts: the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS) included.

ELSA cohort was 55.2% female, and the HRS cohort was 59.8% female, with an average age of 63.5 years.

Blood pressure was collected at three different study visits for the ELSA cohort and at two different visits for the HRS cohort.

Higher systolic and pulse pressures were associated with increased global cognitive decline, and diastolic blood pressure was inversely associated with cognitive decline.

Increased systolic blood pressure and pulse pressure were associated with an increased risk of dementia; an inverse association was shown with diastolic blood pressure.

A level of above approximately 80 mm Hg showed no benefit in either cohort.

Higher pulse pressure was associated with higher mortality rates in both cohorts; inverse association between cumulative diastolic blood pressure and mortality.

Authors note that it is worthwhile to track pulse pressure over time.

Results of this study regarding diastolic pressure differ from the CARDIA study done in younger adults. 

Atrial stiffness and left ventricular hypertrophy can occur with consistently elevated blood pressure and lead to lower diastolic pressure.

Results may not be applicable to all demographic groups, as participants from both cohorts were predominately white.

Some of the cognitive tasks may have lacked sensitivity in detecting small cognitive changes.

Discrepancies between measurements of executive function may have affected the total cognition results between cohorts.

Due to the observational nature of this study, causal relationships cannot be determined.

"In middle-aged and older individuals, efforts may be required to control long-term systolic blood pressure and simultaneously maintain adequate diastolic blood pressure."

"Controlling long-term pulse pressure could be beneficial to both neurocognition and longevity." 

A study published in the Journal of the American College of Cardiology

Mentioned in this article:

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Journal of the American College of Cardiology (JACC)

Scientific Journal providing information about cardiovascular diesases.

Wuxiang Xie

Associate Professor in Clinical Research Institute at Peking University Health Science Center, Beijing, China

Topics mentioned on this page:
Blood Pressure, Mental Health