Sex and Age Differences in the Association of Blood Pressure and Hypertension With Cognitive Function in the Elderly: The Rancho Bernardo Study

Abstract

Objectives: This study examines sex and age differences in associations of systolic and diastolic blood pressure (SBP, DBP), pulse pressure and hypertension with cognitive function in a community-dwelling population. Design: Cross-sectional study. Setting: Research clinic visit in 1988-91. Participants: Participants were 693 men and 1022 women aged 50-97 Measurements: Blood pressure was measured and 12 cognitive function tests were administered. Results: Average age was 73.8±9.9 in men and 73.2±9.3 in women; 62.6% of men and 63.4% of women were hypertensive (SBP≥140 mmHg, DBP≥90 mmHg, or antihypertensive medication use). Each 5-unit increment in SBP, DBP, or pulse pressure and categorical hypertension was associated with significantly increased odds of poor verbal fluency performance in men and poor Trails B performance in women, with strongest associations for hypertension (OR=1.97, CI:1.01,3.85 in men; OR=1.51, CI:1.01,2.26 in women). After age stratification, associations remained statistically significant in younger (<80 years ) but not older (≥80 years) participants. Conclusion: Blood pressure as a continuous or categorical variable was associated with poor performance on cognitive function tests, but domains varied by sex and associations were found only in those younger than 80 years. The absent associations in those aged 80 years and older could support the hypothesis that increased blood flow is required to maintain cerebral perfusion with advancing age, or could reflect a survivor effect.

A survey of cognitive function in peritoneal dialysis patients

“…In previous studies, the urea clearance index (Kt/V), low calcium, high phosphorus, low 25(OH)D3 level, and high parathyroid hormone levels were demonstrated as independent factors to affect cognitive function [18][19][20]. However, there was no significant effect on cognitive function seen when examining anxiety, depression, activity, diabetes, hypertension, creatinine, urea nitrogen, hemoglobin, albumin, total cholesterol, triglyceride, and the clearance rate of total creatinine in this study.…”

Hypertension differentially impacts cognition in men and women in early midlife

“…Our results reflect this pattern, with hypertensive participants overall performing worse on measures of attention, working memory and associative memory compared to normotensive participants. Several studies comparing men and women suggest that hypertension may put women at greater risk for worse performance or decline in executive function (Cerhan et al, 1998; Kritz‐Silverstein et al, 2017; Singh‐Manoux & Marmot, 2005). Midlife hypertension in women has also been associated with worse verbal memory (Singh‐Manoux & Marmot, 2005) and visual memory (Waldstein & Katzel, 2004).…”

Correlation of emotional disorders as manifestations of geriatric syndrome

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