Systolic Blood Pressure and Cognition in the Elderly: The Northern Manhattan Study

Xiaoyan Sun, Chuanhui Dong, Bonnie E. Levin, Michelle Caunca, Adina Zeki Al Hazzourie, Janet T. Derosa, Yaakov Stern, Ying Kuen Cheung, Mitchell S.V. Elkind, Tatjana Rundek, Clinton B. Wright, Ralph L. Sacco, Wei Qiao Qiu

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Increasing evidence suggests that hypertension is a risk factor for cognitive impairment and dementia. The relationship between blood pressure and cognition in a racially and ethnically diverse population remains unclear. Objective: To study association of blood pressure with cognition cross-sectionally and longitudinally in the elderly. Methods: Participants are stroke-free individuals from the racially and ethnically diverse Northern Manhattan Study (NOMAS) (n = 1215). General linear models are constructed to examine blood pressure in relation to cognition cross-sectionally and longitudinally at a five-year follow-up. Results: We found a cross-sectional association of systolic blood pressure (SBP) with word fluency/semantic memory, executive function, and processing speed/visual motor integration (VMI) function. This association was independent of demographics, vascular risk factors, white matter hyperintensity volume (WMHV), and carotid intima-media thickness (cIMT). The cross-sectional association of SBP with processing speed/VMI and executive function was attenuated after adjusting anti-hypertension medications in the models. Baseline SBP was associated with the change of processing speed/VMI function after adjusting vascular risk factors, WMHV, and cIMT at a 5-year follow-up. This longitudinal association was not found after adjusting anti-hypertension medications in the models. Further analyses revealed that individuals with category SBP from < 120 mmHg to≥140 mmHg had a linear decline in processing speed/VMI function at a 5-year follow-up. Conclusion: We show that SBP is negatively associated with cognition cross-sectionally and longitudinally in the elderly. Anti-hypertension treatment eliminates the negative association of SBP with processing speed/VMI function longitudinally. Our findings support the treatment of stage 1 systolic hypertension in the elderly.

Original languageEnglish (US)
Pages (from-to)689-699
Number of pages11
JournalJournal of Alzheimer's Disease
Volume82
Issue number2
DOIs
StatePublished - 2021
Externally publishedYes

Keywords

  • Cognition
  • Northern manhattan study (NOMAS)
  • Race/ethnicity
  • Systolic blood pressure

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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