Hypertension and neuropsychological performance in men: Interactive effects of age.

Waldstein, Shari R.; Jennings, J. Richard; Ryan, Christopher M.; Muldoon, Matthew F.; Shapiro, Alvin P.; Polefrone, Joanna M.; Fazzari, Tara V.; Manuck, Stephen B.

doi:10.1037/0278-6133.15.2.102

Cited by 83 publications

(73 citation statements)

References 35 publications

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“…These specific conditions were chosen given the association that has been demonstrated in the elderly between neurocognition and hypertension (Waldstein et al, 1996), atherosclerotic heart disease (Roine et al, 1993), diabetes (Bruce et al, 2003), and stroke/transient ischemic attack (Meyers et al, 2000;Honig et al, 2003;Rockwood et al, 2003).…”

Section: Apoe Genotypingmentioning

confidence: 99%

No association between subjective memory complaints and apolipoprotein E genotype in cognitively intact elderly

Harwood

Barker

Ownby

et al. 2004

Int J Geriat Psychiatry

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Section: Apoe Genotypingmentioning

confidence: 99%

No association between subjective memory complaints and apolipoprotein E genotype in cognitively intact elderly

Harwood

Barker

Ownby

et al. 2004

Int J Geriat Psychiatry

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“…Digit Vigilance, Recurrent Words (% hits), Elithorn Maze completion time, and Grooved Pegboard insertion time will be performed [48][49][50][51]. Such tests, characterized as tests of attention (former two) and psychomotor speed, showed impairment in previous smaller studies examining effects of statins and constitute, together, the primary outcome [22,23,52].…”

Section: Cognitive Testsmentioning

confidence: 99%

The UCSD Statin Study: a randomized controlled trial assessing the impact of statins on selected noncardiac outcomes

Golomb

Criqui

White

et al. 2004

Controlled Clinical Trials

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There has been persistent controversy regarding possible favorable or adverse effects of statins or of cholesterol reduction on cognition, mood and behavior (including aggressive or violent behavior), muscle function, and quality of life. The UCSD Statin Study seeks to ascertain the beneficial or adverse effects of statin cholesterol-lowering drugs on a set of noncardiac endpoints, including cognition, behavior, and serotonin biochemistry. The study will enroll 1000 subjects (minimum 20% female) of mixed ethnicity from San Diego. Subjects must be age 20 and older, postmenopausal if female, without known cardiovascular disease or diabetes, and with LDLcholesterol between 115 and 190 mg/dl. Subjects will be randomized to a double-blind, placebocontrolled trial with assignment 1/3, 1/3, 1/3 to placebo, simvastatin 20 mg, or pravastatin 40 mg (equipotent LDL-cholesterol-lowering doses for drug arms with simvastatin and pravastatin chosen to represent the extremes of the lipophilicity spectrum) for 6 months of treatment followed by 2 months postcessation follow-up. Primary outcomes are cognition (cognitive battery), irritability/aggression (behavior measure), and serotonin (gauged by whole blood serotonin), assessed as the difference between baseline and 6 months, judging combined statin groups vs. placebo. Secondary outcomes include mood (CES-D and Wakefield depression inventory), quality of life (SF-12V), sleep (Leeds sleep scale, modified), and secondary aggression measures (Conflict Tactics Scale; Overt Aggression Scale, Modified). Cardiovascular reactivity will be examined in a 10% subset. As additional secondary endpoints, primary and selected secondary outcomes will be assessed by statin assignment (lipophilic simvastatin vs. hydrophilic pravastatin). "Reversibility" of changes, if any, at 2 months postcessation will be determined. If effects (favorable or unfavorable) are identified, we will seek to ascertain whether there are baseline variables that predict who will be most susceptible to these favorable or adverse noncardiac effects (i.e., effect modification). NIH Public Access BackgroundStatins are important and widely prescribed drugs, with well-documented and incontrovertible cardiac benefits. However, controversy remains regarding the existence and impact of noncardiac effects, including central nervous system (CNS) effects. The University of California-San Diego (UCSD) Statin Study, a National Institutes of Health/ National Heart Lung and Blood Institute-funded double-blind, placebo-controlled study, seeks to address these issues through a complex battery of tests assessing noncardiac outcomes pertaining to cognition, behavior, quality of life, and biochemistry, among other endpoints. This paper provides the general methodology employed and addresses certain theoretical issues in study design.Statin cholesterol-lowering drugs (HMG-CoA reductase inhibitors) are the most prescribed drugs in the United States and the world and contributed substantially to prescription drug cost increases in 200...

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“…21 In contrast to longitudinal findings, cross-sectional studies indicate that younger adult hypertensive individuals may be more vulnerable to BP-related decrement in cognitive functioning than older hypertensive individuals. 10,22 This phenomenon may be an artifact of cross-sectional designs. 1,2,10 However, the possibility that younger adult hypertensive individuals exhibit greater cognitive decline than older hypertensive individuals has not been tested with a longitudinal design that included persons younger than 47 years of age.…”

mentioning

confidence: 99%

Blood Pressure-Related Cognitive Decline

Elias

Elias²,

Robbins³

et al. 2004

Hypertension

178

117

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Abstract-Systolic and diastolic blood pressures have been inversely related to cognitive performance in prospective and cross-sectional studies. However, in large, community-based samples, these findings have been limited to older adults. In this 20-year longitudinal study, we examined the relationship between baseline blood pressure and cognitive decline for 529 participants using 2 age groups (18 to 46 years and 47 to 83 years). Cognitive performance was measured over multiple examinations with the Wechsler Adult Intelligence Scale from which 4 scores were derived by factor analysis. A 2-stage growth curve method of analysis was used to model cognitive change. Results indicated that higher levels of baseline systolic blood pressure, diastolic blood pressure, mean arterial pressure, and blood pressure categories as defined by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were significantly associated with decline in Visualization/Fluid abilities in both younger and older age groups. Young adults are as susceptible to blood pressure-related longitudinal decline in cognitive performance as are older adults. Key Words: blood pressure Ⅲ age Ⅲ arterial hypertension Ⅲ cognition Ⅲ prospective studies Ⅲ risk factors H ypertension is related to poorer cognitive performance in adults, 1,2 and hypertension-related changes in the brain are well-documented. 3-9 Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels have been inversely related to cognitive performance level. 2,10,11 Moreover, DBP and SBP levels in midlife have been inversely associated with performance levels on cognitive tests administered at later ages. 9,[12][13][14] It is important to determine whether baseline BP values are associated with accelerated cognitive change with advancing age. Longitudinal designs are methodologically superior to cross-sectional designs because BP level can be related to intra-individual decline in cognitive functioning. 15,16 Most of the longitudinal studies using large, community-based samples have involved only midlife or older individuals. [17][18][19][20] Recently, Knopman et al studied persons ranging in age from 47 to 70 years and found that hypertension was related to cognitive decline from baseline to 6-year follow-up, but only for persons aged 58 to 70 years. 21 In contrast to longitudinal findings, cross-sectional studies indicate that younger adult hypertensive individuals may be more vulnerable to BP-related decrement in cognitive functioning than older hypertensive individuals. 10,22 This phenomenon may be an artifact of cross-sectional designs. 1,2,10 However, the possibility that younger adult hypertensive individuals exhibit greater cognitive decline than older hypertensive individuals has not been tested with a longitudinal design that included persons younger than 47 years of age. The major objective of the present study was to compare older and younger adults with respect to BP-associated cognitive decline using a prospective longit...

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Hypertension and neuropsychological performance in men: Interactive effects of age.

Cited by 83 publications

References 35 publications

No association between subjective memory complaints and apolipoprotein E genotype in cognitively intact elderly

No association between subjective memory complaints and apolipoprotein E genotype in cognitively intact elderly

The UCSD Statin Study: a randomized controlled trial assessing the impact of statins on selected noncardiac outcomes

Blood Pressure-Related Cognitive Decline

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