(Stroke. 1998;29:2334-2340.)
© 1998 American Heart Association, Inc.
Original Contributions |
Systolic Blood Pressure Tracking Over 25 to 30 Years and Cognitive Performance in Older Adults
From the Center for Health Sciences, SRI International (G.E.S., D.C.) Menlo Park, Calif, and the University of New Mexico Medical Center (A.L.), Albuquerque, NM.
Objective—To determine the extent to which individual changes in systolic blood pressure (SBP) over a 30-year interval are associated with differential neuropsychological outcomes in old age.
Methods—Seven hundred seventeen survivors from the Western
Collaborative Group Study, a longitudinal study of
cardiovascular risk factors now in its 38th year of
follow-up, with blood pressures measured in middle age (mean=45 years)
and in old age (mean=75 years) and neuropsychological tests
administered at follow-up were included in this analysis.
Participants were grouped according to 30-year change in SBP
(increased, decreased, or "normal"). Analyses focused on
comparisons of neuropsychological performance of "high SBP
trackers" (ie, those with persistent SBP
140 mm Hg
throughout adult life) and of SBP "decreasers" with the
performance of those whose SBP was either stable or changed in
an expected way over time.
Results—Only 7.5% of participants had elevated SBP in middle age, but 43.8% of participants had elevated SBP in old age. After adjustment for age, education, depression, clinically defined stroke, and use of antihypertensive medications and after exclusion of individuals with impaired cognitive performance at follow-up, high SBP trackers, 5.0% (n=36), performed consistently less well than the "normal" SBP subgroups on a composite measure of verbal learning and memory (P=0.04). When compared with the "normal" SBP subgroup, the SBP decreasers, 5.3% (n=38), performed less well on speeded performance (P=0.03).
Conclusions—There is a relatively small group of people who maintain elevated SBP throughout their adult lives. These persons are at increased risk for reduced verbal learning and memory function. There is also a group of individuals who experience a decrease in SBP and who are at risk for decreased psychomotor speed. Delineation of these 2 SBP subgroups may lead to further clarification of the effects of SBP on neurobehavioral function in older adults.
Key Words: aging • blood pressure • cognition • neuropsychology
This article has been cited by other articles:
 |
|
 |
|
  N. Coley, S. Andrieu, V. Gardette, S. Gillette-Guyonnet, C. Sanz, B. Vellas, and A. Grand Dementia Prevention: Methodological Explanations for Inconsistent Results Epidemiol. Rev., November 1, 2008; 30(1): 35 - 66. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. M. Abbatecola, M. Barbieri, M. R. Rizzo, R. Grella, M. T. Laieta, E. Quaranta, A. M. Molinari, M. Cioffi, P. Fioretto, and G. Paolisso Arterial Stiffness and Cognition in Elderly Persons With Impaired Glucose Tolerance and Microalbuminuria J. Gerontol. A Biol. Sci. Med. Sci., September 1, 2008; 63(9): 991 - 996. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L.C. Vogels, P. Scheltens, J. M. Schroeder-Tanka, and H. C. Weinstein Cognitive impairment in heart failure: A systematic review of the literature Eur J Heart Fail, May 1, 2007; 9(5): 440 - 449. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Staessen, T. Richart, and W. H. Birkenhager Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain Hypertension, March 1, 2007; 49(3): 389 - 400. [Full Text] [PDF]
|
|
|
|
 |
|
 K. Insel, D. Morrow, B. Brewer, and A. Figueredo Executive function, working memory, and medication adherence among older adults. J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2006; 61(2): P102 - P107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. D. Hill, A. M. Burdette, J. L. Angel, and R. J. Angel Religious Attendance and Cognitive Functioning Among Older Mexican Americans J. Gerontol. B. Psychol. Sci. Soc. Sci., January 1, 2006; 61(1): P3 - P9. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Waldstein, P. P. Giggey, J. F. Thayer, and A. B. Zonderman Nonlinear Relations of Blood Pressure to Cognitive Function: The Baltimore Longitudinal Study of Aging Hypertension, March 1, 2005; 45(3): 374 - 379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Seshadri, P. A. Wolf, A. Beiser, M. F. Elias, R. Au, C. S. Kase, R. B. D'Agostino, and C. DeCarli Stroke risk profile, brain volume, and cognitive function: The Framingham Offspring Study Neurology, November 9, 2004; 63(9): 1591 - 1599. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. K. Elias, M. F. Elias, M. A. Robbins, and M. M. Budge Blood Pressure-Related Cognitive Decline: Does Age Make a Difference? Hypertension, November 1, 2004; 44(5): 631 - 636. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Qiu, E. von Strauss, B. Winblad, and L. Fratiglioni Decline in Blood Pressure Over Time and Risk of Dementia: A Longitudinal Study From the Kungsholmen Project Stroke, August 1, 2004; 35(8): 1810 - 1815. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Roher, C. Esh, T. A. Kokjohn, W. Kalback, D. C. Luehrs, J. D. Seward, L. I. Sue, and T. G. Beach Circle of Willis Atherosclerosis Is a Risk Factor for Sporadic Alzheimer's Disease Arterioscler Thromb Vasc Biol, November 1, 2003; 23(11): 2055 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Ulmer, C. Kelleher, G. Diem, and H. Concin Long-term tracking of cardiovascular risk factors among men and women in a large population-based health system: The Vorarlberg Health Monitoring & Promotion Programme Eur. Heart J., June 1, 2003; 24(11): 1004 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Murray, K. A. Lane, S. Gao, R. M. Evans, F. W. Unverzagt, K. S. Hall, and H. Hendrie Preservation of Cognitive Function With Antihypertensive Medications: A Longitudinal Analysis of a Community-Based Sample of African Americans Arch Intern Med, October 14, 2002; 162(18): 2090 - 2096. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Hanon and D. Leys Cognitive decline and dementia in the elderly hypertensive Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S32 - S38. [PDF]
|
|
|
|
|
|
Y. Yamamoto, I. Akiguchi, K. Oiwa, M. Hayashi, T. Kasai, and K. Ozasa Twenty-four-Hour Blood Pressure and MRI as Predictive Factors for Different Outcomes in Patients With Lacunar Infarct Stroke, January 1, 2002; 33(1): 297 - 305. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Kadish, T. van Groen, and J. M. Wyss Chronic, Severe Hypertension Does Not Impair Spatial Learning and Memory in Sprague-Dawley Rats Learn. Mem., March 1, 2001; 8(2): 104 - 111. [Abstract] [Full Text]
|
|