Blood Pressure Variability and Cognitive Function: a Scoping Review

Abstract

Purpose of Review To conduct a scoping review of articles which have evaluated BPV and cognitive function. Articles with keywords, titles or abstracts containing the terms 'cognitive' OR 'cognition' OR 'dementia' AND 'blood pressure variability' were identified from CINAHL, Medline, PMC and Web of Science. Recent Findings Methods of acquisition and analysis of BPV and cognitive measurements and their relationship were extracted from selected articles. Of 656 studies identified, 53 articles were selected. 25 evaluated long-term (LTBPV), nine midterm (MTBPV), 12 short-term (STBPV) and nine very-short-term BPV (VSTBPV) with conflicting findings on the relationship between BPV and cognition. Variations existed in devices, period and procedure for acquisition. The studies also utilized a wide range of methods of BPV calculation. Thirteen cognitive assessment tools were used to measure global cognition or domain functions which were influenced by the population of interest. Summary The interpretation of available studies was hence limited by heterogeneity. There is an urgent need for standardization of BPV assessments to streamline research on BPV and cognition. Future studies should also establish whether BPV could be a potential modifiable risk factor for cognitive decline, as well as a marker for treatment response.

Hypotensive episodes at 24-h Ambulatory Blood Pressure Monitoring predict adverse outcomes in Parkinson’s Disease

“…This observation seems in line with the recent ndings by Ruiz Barrio and colleagues [38], who in a large pathological study on PD and Multiple System Atrophy patients observed an independent association between OH and cognitive impairment, but did not nd differences in αsynuclein, β-amyloid, or tau pathology in patients with and without OH. Finally, in the present study, the strength and the signi cance of the association with cognitive impairment was greater for ABPM hypotensive episodes than o ce OH, further con rming the usefulness of ABPM in capturing the complexity of the circadian uctuation of BP, and suggesting a possible role of BP variability in determining worse functional outcomes [39].…”

Hypertension, Neurodegeneration, and Cognitive Decline

“…In recent meta-analyses combining 53 (9 very short-, 12 short-, 9 mid-, and 23 long-term) and 19 (4 short-, 4 mid-, 11 long-term) studies, worse cognitive performance was associated with short-, medium-, and long-term BPV. 23,24 In contrast, low BPV over the very short term elevates the risk of poor cognitive outcomes, perhaps due to impairment of the ability to adjust perfusion commensurate with demand (eg, postural changes). 23 In summary, hypertension, particularly in mid-life, is associated with worse long-term cognitive outcomes, and increased short-, mid-, and long-term BPV are emergent risk factors for cognitive decline and dementia, especially in the elderly.…”

“…In recent meta-analyses combining 53 (9 very short-, 12 short-, 9 mid-, and 23 long-term) and 19 (4 short-, 4 mid-, 11 long-term) studies, worse cognitive performance was associated with short-, medium-, and long-term BPV. 23,24 In contrast, low BPV over the very short term elevates the risk of poor cognitive outcomes, perhaps due to impairment of the ability to adjust perfusion commensurate with demand (eg, postural changes). 23…”

“…23,24 In contrast, low BPV over the very short term elevates the risk of poor cognitive outcomes, perhaps due to impairment of the ability to adjust perfusion commensurate with demand (eg, postural changes). 23…”

“…23,24 In contrast, low BPV over the very short term elevates the risk of poor cognitive outcomes, perhaps due to impairment of the ability to adjust perfusion commensurate with demand (eg, postural changes). 23 In summary, hypertension, particularly in mid-life, is associated with worse long-term cognitive outcomes, and increased short-, mid-, and long-term BPV are emergent risk factors for cognitive decline and dementia, especially in the elderly.…”