Is Blood Pressure An Important Variable in Research on Aging and Neuropsychological Test Performance?

Elias, Merrill F.; Robbins, Michael A.; Schultz, Norman R.; Pierce, Thomas W.

doi:10.1093/geronj/45.4.p128

Cited by 96 publications

(72 citation statements)

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“…In addition, relatively recent evidence has emerged which associates adverse outcomes in the general population with other HR 16,17 and BP thresholds. [18][19][20][21] Beyond the clinical consequences of alterations in HR and BP, persons with SCI may experience loss of independence and life quality related to the inability to adequately maintain cardiovascular homeostasis; however, until we gain a better understanding of the prevalence of these abnormalities, the development and testing of effective treatment strategies will not be a priority. Therefore, we measured HR and BP during routine annual physical examinations in a sample of veterans with SCI from an urban Veterans Affairs Medical Center.…”

Section: Introductionmentioning

confidence: 99%

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

Wecht

Zhu

Weir

et al. 2013

The Journal of Spinal Cord Medicine

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Objective: Decentralized autonomic cardiovascular regulation may lead to increased prevalence of heart rate (HR) and blood pressure (BP) abnormalities in veterans with SCI. In addition, comorbid medical conditions and prescription medication use may increase HR and BP abnormalities. These abnormalities include bradycardia, and tachycardia, hypotension, hypertension as well as autonomic dysreflexia and orthostatic hypotension; the prevalence of which is unknown. Design: HR and BP data were measured during a routine annual physical examination in 64 veterans with SCI. Measurements of HR and BP were recorded in the seated and supine positions to document the influence of body position and to document intra-subject variability in these assessments. Results: All subjects were chronically injured (20 ± 14 years), 33 subjects were tetraplegic (T: C3-C8), nine had high paraplegia (HP: T1-T6), and 22 had low paraplegia (LP: T7-L2). Regardless of position, the prevalence of bradycardia was increased in the T group, whereas prevalence of tachycardia was increased in the HP and LP groups. Systolic hypotension was more common in the T and HP groups than the LP group and positional effects were most evident in the T group. Systolic hypertension was comparable in the T and HP groups but was twice as prevalent in the LP group. Increased prevalence of individuals with three or more medical conditions and prescribed three or more medications which might influence HR and BP was observed. Conclusion: Decentralized autonomic regulation, comorbid medical conditions, and prescription medication use in veterans with SCI result in HR and BP abnormalities; our data suggest that these abnormalities vary depending on the level of injury and orthostatic positioning.

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Section: Introductionmentioning

confidence: 99%

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

Wecht

Zhu

Weir

et al. 2013

The Journal of Spinal Cord Medicine

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“…With regard to blood pressure (BP), many studies have shown that, over a wide range of BP values and with adjustment for hypertensionrelated complications, both systolic and diastolic BP are inversely related to the level of cognitive performance and longitudinal decline in performance. [1][2][3][4][5][6][7][8][9] The most widely accepted mechanism by which high BP reduces cognitive ability is via its effect on brain structure and function. 10 -16 Hypertension is associated with acceleration of atherosclerosis in the large arteries and is associated with medial thickening of the intracerebral vessels leading to cerebral white matter hypoperfusion and ischemic rarefaction.…”

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confidence: 99%

“…16 A causal association between higher BP and lower cognition has been suggested because of the observation of a "doseresponse" effect in studies relating BP and cognition. [1][2][3][7][8][9] Both the duration and the magnitude of BP elevation have been related inversely to cognitive performance. 9 However, the use of the duration of hypertension as a marker of the chronic hemodynamic burden posed by high BP is challenged by the lack of precision in identifying the exact date of hypertension onset in epidemiological studies.…”

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confidence: 99%

Left Ventricular Mass, Blood Pressure, and Lowered Cognitive Performance in the Framingham Offspring

et al. 2007

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Abstract-The purpose of this study was to determine whether echocardiographic left ventricular mass is related to cognitive performance beyond casual blood pressure adjusting for the influence of other vascular risk factors. We used multivariable regression analyses to relate left ventricular mass assessed at a routine examination (1995)(1996)(1997)(1998) to measures of cognitive ability obtained routinely (1998 -2001) A lthough there is an extensive literature on the association of blood pressure and cognitive performance, little information is available regarding the relationship of left ventricular mass (LVM) to cognition. With regard to blood pressure (BP), many studies have shown that, over a wide range of BP values and with adjustment for hypertensionrelated complications, both systolic and diastolic BP are inversely related to the level of cognitive performance and longitudinal decline in performance. [1][2][3][4][5][6][7][8][9] The most widely accepted mechanism by which high BP reduces cognitive ability is via its effect on brain structure and function. 10 -16 Hypertension is associated with acceleration of atherosclerosis in the large arteries and is associated with medial thickening of the intracerebral vessels leading to cerebral white matter hypoperfusion and ischemic rarefaction. 16 A causal association between higher BP and lower cognition has been suggested because of the observation of a "doseresponse" effect in studies relating BP and cognition. [1][2][3][7][8][9] Both the duration and the magnitude of BP elevation have been related inversely to cognitive performance. 9 However, the use of the duration of hypertension as a marker of the chronic hemodynamic burden posed by high BP is challenged by the lack of precision in identifying the exact date of hypertension onset in epidemiological studies. LVM is strongly associated with long-term BP cross-sectionally 10 and is a predictor of future risk of hypertension in nonhypertensive individuals 11 In addition, LVM is a surrogate marker of cardiovascular target organ damage and is associated with incidence of cardiovascular disease prospectively. [12][13][14][15][16] These findings suggest that LVM, as determined by echocardiography, should relate to levels of cognitive performance in a manner similar to, but not necessarily identical with, BP.Because LVM is a time-integrated correlate of exposure to BP and to other cardiovascular risk factors, it may serve as a marker of the chronicity and the degree of BP elevation and an indicator of long-term burden of vascular risk factors.

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“…[3][4][5][6][7][8][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.…”

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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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Is Blood Pressure An Important Variable in Research on Aging and Neuropsychological Test Performance?

Cited by 96 publications

References 0 publications

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

A prospective report on the prevalence of heart rate and blood pressure abnormalities in veterans with spinal cord injuries

Left Ventricular Mass, Blood Pressure, and Lowered Cognitive Performance in the Framingham Offspring

Blood Pressure-Related Cognitive Decline

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