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- Title
Blood Pressure Variability and Cognitive Decline: A Post Hoc Analysis of the SPRINT MIND Trial.
- Authors
Sible, Isabel J; Nation, Daniel A
- Abstract
Background Blood pressure (BP) variability (BPV) is an emerging risk factor for cognitive impairment and dementia, but relationships with cognition in the context of antihypertensive strategies remain unclear. We examined whether visit-to-visit BPV relates to cognitive change based on antihypertensive treatment type. Methods In this post hoc analysis of the SPRINT MIND trial, 2,348 participants underwent 4 BP measurements over a 9-month period after treatment randomization (standard vs. intensive BP lowering) and ≥ 1 neuropsychological evaluation thereafter. BPV was calculated as tertiles of BP SD. Participants underwent cognitive testing at baseline and every 2 years during the planned 4-year follow-up. Cognitive composite scores were calculated for global cognition, memory, language, executive function, and processing speed. Linear mixed models investigated relationships between BPV, antihypertensive treatment group, and time on cognitive composite scores. Results Elevated BPV was associated with the fastest decline in processing speed (ß = −.07 [95% CI −.12, −.01]; P = 0.02) and executive function (ß = −.08 [95% CI −.16, −.006]; P = 0.03) in the standard treatment group only. BPV was not related to cognitive change in the intensive treatment group. Mean/minimum/maximum BP was not associated with cognitive composite scores over time in either antihypertensive treatment group. Conclusions Elevated BPV remains a risk for cognitive decline despite strictly controlled BP levels, in the standard treatment group. Specific declines were observed in processing speed and executive function, domains often impacted by cerebrovascular disease and may underpin risk for dementia and cerebrovascular disease associated with BPV. Clinical trial information: ClinicalTrials.gov; NCT01206062.
- Subjects
COGNITIVE processing speed; BLOOD pressure; COGNITION disorders; COGNITIVE testing; EXECUTIVE function; VARIABILITY (Psychometrics)
- Publication
American Journal of Hypertension, 2023, Vol 36, Issue 3, p168
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpac128