Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke Cognitive Impairment

Lee, Kang Po; Chang, Alice Y.W.; Sung, Pi Shan

doi:10.3390/biomedicines9070773

Cited by 9 publications

(8 citation statements)

References 236 publications

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“…Mechanism linking diabetes mellitus and PSCI/dementia A previous review demonstrated that PSCI depends on multiple factors, including the location of the stroke, duration of the initial inflammatory response, late aberrant neurogenesis, and baseline brain pathologies. 7 The activation of microglia seems to play an important role in the inflammatory response. 8 Chronic hyperglycemia leads to pro-inflammatory microglial proliferation via the endothelin-1 system.…”

Section: Diabetes Mellitus and Psci/post-stroke Dementia (Psd)mentioning

confidence: 99%

Association between diabetes mellitus and post‐stroke cognitive impairment

Lee

Chen

Wang

2022

J of Diabetes Invest

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Stroke survivors suffer from various physical, emotional, and cognitive impairments. These changes are dynamic and depend on multiple factors, including underlying diseases, baseline brain function and pathology, the site of the stroke and the post‐stroke inflammation, neurogenesis as well as the subsequent remodeling of the neuro‐network. First we review the structural and pathological changes of the brain in stroke survivors with diabetes mellitus, which may lead to post‐stroke cognitive dysfunction. Second, we provide evidence of hyperglycemia, diabetes mellitus, hypoglycemia, and their relationship with post‐stroke cognitive impairment (PSCI) and post‐stroke dementia (PSD). In addition to conventional biomarkers, such as HbA1c, we also provide other novel tools to predict PSCI/PSD, such as glycemic variability, receptor for advanced glycation end products, and gut microbiota. Finally, we attempt to provide some modifying methods for glycemic control, focusing on the prevention of PSCI/PSD.

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Section: Diabetes Mellitus and Psci/post-stroke Dementia (Psd)mentioning

confidence: 99%

Association between diabetes mellitus and post‐stroke cognitive impairment

Lee

Chen

Wang

2022

J of Diabetes Invest

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“…Beyond modifying average BP levels, there has been recent interest in BP variability (BPV) as a risk factor for dementia, in part due to BP's highly variable nature and its potential therapeutic implications [5][6][7][8] . Emerging evidence suggests elevated BPV over the longer term (e.g., over months to years or "visit-to-visit" BPV) and shorter term (e.g., over minutes, days) is associated with cognitive impairment and decline 8 , incidence and progression of dementia, including AD and vascular dementia 7,[9][10][11][12] , cerebrovascular disease [13][14][15] , stroke 16,17 , and AD pathology 18 , independent of average BP levels 8 . Further evidence indicates these relationships may be especially pronounced in individuals at increased genetic risk for AD through the apolipoprotein (APOE) e4 allele [19][20][21] .…”

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confidence: 99%

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Sible

Yew

Jang

et al. 2022

Sci Rep

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Blood pressure variability is an emerging risk factor for Alzheimer’s disease in older adults, independent of average blood pressure levels. Growing evidence suggests increased blood pressure variability is linked to Alzheimer’s disease pathophysiology indexed by cerebrospinal fluid and positron emission tomography markers, but relationships with plasma Alzheimer’s disease markers have not been investigated. In this cross-sectional study of 54 community-dwelling older adults (aged 55–88, mean age 69.9 [8.2 SD]), elevated blood pressure variability over 5 min was associated with lower levels of plasma Aβ1–42 (standardized ß = − 0.36 [95% CI − 0.61, − 0.12]; p = 0.005; adjusted R2 = 0.28) and Aβ1–42: Aβ1–40 ratio (ß = − 0.49 [95% CI − 0.71, − 0.22]; p < 0.001; adjusted R2 = 0.28), and higher levels of total tau (ß = 0.27 [95% CI 0.01, 0.54]; p = 0.04; adjusted R2 = 0.19) and Ptau181:Aβ1–42 ratio (ß = 0.26 [95% CI 0.02, 0.51]; p = 0.04; adjusted R2 = 0.22). Findings suggest higher blood pressure variability is linked to plasma biomarkers of increased Alzheimer’s disease pathophysiology.

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“…Post-stroke cognitive impairment (PSCI) is one of the most prevalent stroke consequences, and it can have a detrimental impact on the rehabilitation of stroke patients’ athletic function, daily living abilities, and a financial burden 1 . Stroke survivors may experience a decline in cognitive function and neuropsychiatric symptoms in a short period after stroke 2 . The previous study had demonstrated that the cognitive function in the initial 2 weeks (acute phase) can predict significant cognitive impairment 3 - 6 months after stroke 3 .…”

Section: Introductionmentioning

confidence: 99%

Association Between the Serum Iron and Acute Cognitive Impairment After Stroke: A Cross-Sectional Study

Junxin

et al. 2022

J Geriatr Psychiatry Neurol

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Background Complications such as cognitive impairment are common in stroke victims. The goal of this study was to see if there was a link between blood iron levels and post-stroke cognitive impairment (PSCI) within 2 weeks after stroke. Methods A total of 313 patients with ischemic stroke were recruited and separated into two groups: PSCI (n = 202) and non-PSCI (n = 111). The Mini-mental state examination scale was used to evaluate the cognitive status within 2 weeks after stroke (acute phase). The serum iron levels were divided into 4 layers: Q1 ≤ 11.7 μmol/L, Q2 11.8-15.1 μmol/, Q3 15.2-19.3 μmol/L, Q4 ≥ 19.4 μmol/L, respectively. The connection between serum iron and PSCI was then investigated further using binary logistic regression, which was adjusted for confounders. Results The difference in serum iron levels between the PSCI and non-PSCI group was initially conducted by the Mann-Whitney test, and a significant difference was found (14.5 (11.0-17.8) vs. 16.9 (13.7-21.8), p < .001), with no confounders being adjusted. After adjusting for confounding factors, the binary regression analysis showed that the Q4 layer showed the lowest risk of PSCI, with the Q1 layer being the reference. (odds ratio (OR) = 0.297, 95% confidence interval (CI) = 0.136-0.649, p = 0.002). Conclusion A decreased risk of early-onset PSCI was linked to high serum iron levels. Low serum iron levels were found to be a risk factor for acute cognitive impairment following stroke, which could help physicians identify and take intervention measures early to reduce the risk of cognitive impairment after stroke.

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Association between Blood Pressure, Blood Pressure Variability, and Post-Stroke Cognitive Impairment

Cited by 9 publications

References 236 publications

Association between diabetes mellitus and post‐stroke cognitive impairment

Association between diabetes mellitus and post‐stroke cognitive impairment

Blood pressure variability and plasma Alzheimer’s disease biomarkers in older adults

Association Between the Serum Iron and Acute Cognitive Impairment After Stroke: A Cross-Sectional Study

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