Day-to-day blood pressure variability is associated with lower cognitive performance among the Japanese community-dwelling oldest-old population: the SONIC study

2019 ◽  
Vol 43 (5) ◽  
pp. 404-411 ◽  
Author(s):  
Kayo Godai ◽  
◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Saori Yasumoto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Performance ◽  
Blood Pressure Variability ◽  
Oldest Old ◽  
Community Dwelling

Abstract 16476: Visit-to-Visit Blood Pressure Variability is Associated With Incident Frailty: The Multidomain Alzheimer Preventive Trial (MAPT)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Laure Rouch ◽  
Philipe de Souto Barreto ◽  
Olivier Hanon ◽  
Jacques Amar ◽  
Yves Rolland ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Blood Pressure Variability ◽  
Proportional Hazards ◽  
Antihypertensive Drugs ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Clinical Predictors ◽  
Increased Risk ◽  
Preventive Trial

Introduction: Visit-to-visit blood pressure variability (BPV) has been associated with greater cardiovascular and all-cause mortality, cognitive impairment, and incident dementia. It may also represent a decline in homeostatic mechanisms in blood pressure (BP) regulation associated with frailty, one of the most problematic expression of population aging. Hypothesis: We hypothesized that visit-to-visit systolic (SBPV), diastolic (DBPV), mean arterial (MAPV) and pulse pressure (PPV) variability are associated with greater incident frailty. Methods: We included 1,394 non-frail community-dwelling participants aged ≥ 70 years from the Multidomain Alzheimer Preventive Trial (MAPT) who underwent repeated clinical examinations over a 5-year follow-up period. SBPV, DBPV, MAPV and PPV were evaluated using standard deviation, coefficient of variation (CV), average real variability, successive variation, variation independent of mean and residual standard deviation. Incident frailty was assessed using the Fried phenotype. Cox proportional hazards models were used for the analyses. Results: Higher SBPV was significantly associated with increased risk of incident frailty (1-sd increase of CV: HR = 1.18, 95% CI [1.02-1.37], p=0.03) after adjustment for demographics, body mass index, stroke, ischemic heart disease, diabetes, heart failure, antihypertensive drugs, systolic BP, MAPT intervention groups and baseline pre-frail status. Similar results were observed with all indicators of variability. DBPV and MAPV were not associated with incident frailty (p=0.6 and p=0.2, respectively). Interestingly, higher PPV was also associated with a greater risk of developing frailty over time (1-sd increase of CV: HR = 1.17, 95% CI [1.01-1.35], p=0.03). Conclusion: Independently of BP, higher SBPV and PPV are major clinical predictors of incident frailty. Our findings support the concept of BP physiological dysregulation underlying the frail state and suggest that controlling BP instability could be a promising interventional target in preventing frailty.

scholarly journals ASSOCIATION BETWEEN BLOOD PRESSURE AND COGNITIVE FUNCTION OF COMMUNITY-DWELLING OLDEST OLD IN OKINAWA, JAPAN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S643-S643
Author(s):  
Yukihiro Namihira ◽  
Takashi Tokashiki ◽  
Akio Ishida ◽  
Yusuke Ohya ◽  
Hiroko H Dodge
Keyword(s):  
Blood Pressure ◽  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Decline ◽  
Pulse Pressure ◽  
Cognitive Aging ◽  
Oldest Old ◽  
Community Dwelling ◽  
Vascular Stiffness ◽  
High Cognitive Function

Abstract Background: Adults 80 years and older are the fastest-growing segment of the Japanese population and face a high risk of cognitive decline. There are some evidences connecting hypertension to cognitive decline. In mid-life hypertension is known to have influence the cognitive decline in older age. However, a few study have examined the association between hypertension or vascular stiffness and cognitive function among elderly over 80 years old. We analyzed the associations between vascular stiffness and cognitive function among relatively healthy community-dwelling non-demented oldest old. Method: Data came from the Keys to Optimal Cognitive Aging (KOCOA) study; an ongoing cohort of relatively healthy volunteers aged over 80 years old, living in Okinawa, Japan. In 2017, 105 non-demented (Clinical Dementia Rating < 1) subjects completed three kinds of examination for vascular function (75 % female, mean age (SD) 84.0 (3.0)). We categorized subjects into low and high cognitive function groups using Montreal Cognitive Assessment (MoCA) (25/26 as a cutpoint). Logistic regression models were used to examine the association between cognitive and vascular functions. Results: Narrower pulse pressure, an indicator of lower arterial stiffness, was associated with better cognitive function among subjects, after adjusting for gender, age, and education (p≦0.05), although systolic and diastolic blood pressure were not. Conclusion: Our findings suggest that narrower pulse pressure is related with cognitive preservation. The present study supports the hypothesis that lower arterial stiffness is related with better cognitive function even among the oldest old.

Inverse Relationship Between Depressive Symptoms and Arterial Blood Pressure in Community-Dwelling Oldest-Old Brazilians

2013 ◽  
Vol 61 (3) ◽  
pp. 465-467 ◽  
Author(s):  
Idiane Rosset ◽  
Rosalina Partezani Rodrigues ◽  
Liara Rizzi ◽  
José Canuto-Neto ◽  
Matheus Roriz-Cruz
Keyword(s):  
Blood Pressure ◽  
Depressive Symptoms ◽  
Arterial Blood Pressure ◽  
Inverse Relationship ◽  
Oldest Old ◽  
Community Dwelling ◽  
Arterial Blood

Abstract P160: Long-term Blood Pressure Variability And Cognitive Decline And Dementia Among Community-dwelling Elderly

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Michael E Ernst ◽  
Joanne Ryan ◽  
Enayet K Chowdhury ◽  
Anne M Murray ◽  
Robyn L Woods ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Decline ◽  
Blood Pressure Variability ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Immortal Time Bias ◽  
Incident Dementia ◽  
The Impact

Greater blood pressure variability (BPV) in midlife increases the risk of dementia, but the impact of BPV in cognitively intact older adults is unknown. We examined the risk of incident dementia and cognitive decline associated with long-term, visit-to-visit BPV in participants of the ASPirin in Reducing Events in the Elderly (ASPREE) study, a randomized primary prevention trial of daily low-dose aspirin in community-dwelling adults in Australia and the US aged 70 and older (65 if US minority), who were free of dementia or evidence of cognitive impairment at enrollment. The mean of three BPs using an automated cuff was recorded at baseline and annually; participants also underwent baseline and biennial standardized assessments of global cognition, delayed episodic memory, verbal fluency, processing speed and attention. Cognitive decline was pre-specified as a >1.5 standard deviation (SD) decline in score from baseline on any of the cognitive tests, while incident dementia was a pre-specified secondary endpoint of ASPREE which was adjudicated using DSM-IV criteria. BPV was estimated using within-individual SD of mean systolic BP across baseline and the first two annual visits, and participants with cognitive decline or incident dementia during this period were excluded from the analysis to avoid immortal time bias. After adjustment for key covariates, Cox proportional hazards regression revealed increased risks for dementia and cognitive decline during follow-up for individuals in the highest SD tertile of BPV (Table). Our findings suggest that high BPV in older ages should be considered a potential therapeutic target to preserve cognitive function.

scholarly journals Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People

2015 ◽  
Vol 29 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Claire McDonald ◽  
Mark S. Pearce ◽  
Joanna Wincenciak ◽  
Simon R.J. Kerr ◽  
Julia L. Newton
Keyword(s):  
Blood Pressure ◽  
Older People ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Variability ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Long-Term Blood Pressure Variability and Risk of Cardiovascular Disease Events Among Community-Dwelling Elderly

Hypertension ◽  
2020 ◽  
Vol 76 (6) ◽  
pp. 1945-1952
Author(s):  
Michael E. Ernst ◽  
Enayet K. Chowdhury ◽  
Lawrence J. Beilin ◽  
Karen L. Margolis ◽  
Mark R. Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Blood Pressure Variability ◽  
Community Dwelling ◽  
Sensitivity Analyses ◽  
Link Type ◽  
Increased Risk ◽  
The Impact

High office blood pressure variability (OBPV) in midlife increases the risk of cardiovascular disease (CVD), but the impact of OBPV in older adults without previous CVD is unknown. We conducted a post hoc analysis of ASPREE trial (Aspirin in Reducing Events in the Elderly) participants aged 70-years and older (65 for US minorities) without history of CVD events at baseline, to examine risk of incident CVD associated with long-term, visit-to-visit OBPV. CVD was a prespecified, adjudicated secondary end point in ASPREE. We estimated OBPV using within-individual SD of mean systolic BP from baseline and first 2 annual visits. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% CI for associations with CVD events. In 16 475 participants who survived to year 2 without events, those in the highest tertile of OBPV had increased risk of CVD events after adjustment for multiple covariates, when compared with participants in the lowest tertile (HR, 1.36 [95% CI, 1.08–1.70]; P =0.01). Similar increased risk was observed for ischemic stroke (HR, 1.56 [95% CI, 1.04–2.33]; P =0.03), heart failure hospitalization, or death (HR, 1.73 [95% CI, 1.07–2.79]; P =0.02), and all-cause mortality (HR, 1.27 [95% CI, 1.04–1.54]; P =0.02). Findings were consistent when stratifying participants by use of antihypertensive drugs, while sensitivity analyses suggested the increased risk was especially for individuals whose BP was uncontrolled during the OBPV estimation period. Our findings support increased OBPV as a risk factor for CVD events in healthy older adults with, or without hypertension, who have not had such events previously. Registration— URL: https://www.clinicaltrials.gov ; Unique identifiers: NCT01038583; URL: https://www.isrctn.com ; Unique identifiers: ISRCTN83772183.

Relationship Between Depression and Blood Pressure in Community-Dwelling Oldest-Old Adults in Japan

2013 ◽  
Vol 61 (12) ◽  
pp. 2241-2242 ◽  
Author(s):  
Hissei Imai ◽  
Kiyohito Okumiya ◽  
Taizo Wada ◽  
Michiko Fujisawa ◽  
Ryota Sakamoto ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Oldest Old ◽  
Community Dwelling ◽  
Old Adults

scholarly journals Blood pressure variability and cognitive performance

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P2364-P2364
Author(s):  
W. Bruno Santos ◽  
J. D. Matoso ◽  
T. R. Goncalves ◽  
M. Casanova ◽  
I. Freitas ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cognitive Performance ◽  
Blood Pressure Variability

Abstract P189: Long-term Blood Pressure Variability And Risk Of Cardiovascular Disease Events Among Community-dwelling Elderly

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Michael E Ernst ◽  
Enayet K Chowdhury ◽  
Lawrie Beilin ◽  
Karen L Margolis ◽  
Mark R Nelson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Ischemic Stroke ◽  
Blood Pressure Variability ◽  
The United States ◽  
Community Dwelling ◽  
Main Trial ◽  
All Cause Mortality ◽  
The Impact

Greater blood pressure variability (BPV) in midlife increases risk of future cardiovascular disease (CVD) events, but the impact of BPV in adults who have reached older ages while remaining free of CVD is unknown. We examined risk of overall incident CVD, ischemic stroke subgroup, and all-cause mortality associated with long-term, visit-to-visit BPV in participants of the ASPirin in Reducing Events in the Elderly study, a randomized primary prevention trial of daily low-dose aspirin in community-dwelling adults in Australia and the United States (US) aged 70 and older (65 if US minority) without evidence of CVD. The mean of three blood pressures (BP) using an automated cuff was recorded at baseline and annually. CVD was a prespecified composite secondary endpoint of ASPREE, and included fatal coronary heart disease, nonfatal MI, fatal or nonfatal stroke, or hospitalization for heart failure. All CVD events were adjudicated as part of the main trial. This analysis included participants who survived without CVD to the second annual visit and had BP recorded at baseline, years 1 and 2 (n=16,482). BPV was defined as within-individual standard deviation of mean systolic BP across these visits. Cox proportional hazards regression adjusting for confounders was used to calculate hazard ratios (HR) according to tertile of estimated BPV, with year 2 as time zero to minimize immortal time bias. Our results (Table) show that higher visit-to-visit BPV in older adults without previous CVD is associated with increased risk of future CVD events, ischemic stroke, and all-cause mortality, suggesting that BPV in older ages should be considered a potential therapeutic target for CVD risk-lowering.

Sign in / Sign up

Export Citation Format

Share Document