Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study
Background To understand how blood pressure (BP) from midlife and beyond is related to cognition in older age, a lifespan approach is needed. We assessed the associations of BP levels and variability from midlife on with subsequent cognitive change. Methods and Results The ARIC (Atherosclerosis Risk...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2018-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.009578 |
| _version_ | 1818315132633088000 |
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| author | Yuichiro Yano Michael Griswold Wanmei Wang Philip Greenland Donald M. Lloyd‐Jones Gerardo Heiss Rebecca F. Gottesman Thomas H. Mosley |
| author_facet | Yuichiro Yano Michael Griswold Wanmei Wang Philip Greenland Donald M. Lloyd‐Jones Gerardo Heiss Rebecca F. Gottesman Thomas H. Mosley |
| author_sort | Yuichiro Yano |
| collection | DOAJ |
| description | Background To understand how blood pressure (BP) from midlife and beyond is related to cognition in older age, a lifespan approach is needed. We assessed the associations of BP levels and variability from midlife on with subsequent cognitive change. Methods and Results The ARIC (Atherosclerosis Risk in Communities) Study participants underwent 4 clinic BP measurements (visit 1, 2, 3, and 4 BPs) between 1987 and 1998, and their mean levels and average real variability (ARV) were assessed as exposures. A global cognitive z score, estimated from the Delayed Word Recall Test, Digit Symbol Substitution Test, and Word Fluency Test scores, was calculated at 1996 to 1998 (visit 4) and 2011 to 2013 (visit 5). Among 11 408 participants (mean age, 54 years; 56% women; 21% black race), mean systolic BP (SBP)/diastolic BP (DBP) level was 123/72 mm Hg, and ARVSBP/ARVDBP was 11/7 mm Hg. With linear mixed models, 1‐SD increases of ARVSBP (standardized regression coefficient [95% confidence interval], −0.03 [−0.04 to −0.01] points) and ARVDBP (standardized regression coefficient [95% confidence interval], −0.02 [−0.03 to −0.002] points; both P<0.05), but not mean SBP or DBP levels, were associated with lower global cognitive z scores at visit 4. In contrast, mean SBP (standardized regression coefficient [95% confidence interval], −0.04 [−0.06 to −0.02] points) or DBP (standardized regression coefficient [95% confidence interval], 0.04 [0.02–0.06] points; both P<0.001) level, but not ARVSBP or ARVDBP, was associated with change in global cognitive z scores from visits 4 to 5. Conclusions Greater visit‐to‐visit SBP or DBP variability from midlife on is modestly associated with lower cognitive function, whereas higher mean SBP and lower DBP levels from midlife to later life are modestly associated with cognitive decline in later life. |
| first_indexed | 2024-12-13T09:00:41Z |
| format | Article |
| id | doaj.art-8e7c39f02c1d44e18592be1840c676c9 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T09:00:41Z |
| publishDate | 2018-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-8e7c39f02c1d44e18592be1840c676c92022-12-21T23:53:11ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802018-08-0171510.1161/JAHA.118.009578Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive StudyYuichiro Yano0Michael Griswold1Wanmei Wang2Philip Greenland3Donald M. Lloyd‐Jones4Gerardo Heiss5Rebecca F. Gottesman6Thomas H. Mosley7Department of Preventive Medicine University of Mississippi Medical Center Jackson MSCenter of Biostatistics and Bioinformatics University of Mississippi Medical Center Jackson MSCenter of Biostatistics and Bioinformatics University of Mississippi Medical Center Jackson MSDepartment of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago ILDepartment of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago ILDepartment of Epidemiology University of North Carolina Chapel Hill NCDepartment of Neurology Johns Hopkins University School of Medicine Baltimore MDDivision of Geriatric Medicine University of Mississippi Medical Center Jackson MSBackground To understand how blood pressure (BP) from midlife and beyond is related to cognition in older age, a lifespan approach is needed. We assessed the associations of BP levels and variability from midlife on with subsequent cognitive change. Methods and Results The ARIC (Atherosclerosis Risk in Communities) Study participants underwent 4 clinic BP measurements (visit 1, 2, 3, and 4 BPs) between 1987 and 1998, and their mean levels and average real variability (ARV) were assessed as exposures. A global cognitive z score, estimated from the Delayed Word Recall Test, Digit Symbol Substitution Test, and Word Fluency Test scores, was calculated at 1996 to 1998 (visit 4) and 2011 to 2013 (visit 5). Among 11 408 participants (mean age, 54 years; 56% women; 21% black race), mean systolic BP (SBP)/diastolic BP (DBP) level was 123/72 mm Hg, and ARVSBP/ARVDBP was 11/7 mm Hg. With linear mixed models, 1‐SD increases of ARVSBP (standardized regression coefficient [95% confidence interval], −0.03 [−0.04 to −0.01] points) and ARVDBP (standardized regression coefficient [95% confidence interval], −0.02 [−0.03 to −0.002] points; both P<0.05), but not mean SBP or DBP levels, were associated with lower global cognitive z scores at visit 4. In contrast, mean SBP (standardized regression coefficient [95% confidence interval], −0.04 [−0.06 to −0.02] points) or DBP (standardized regression coefficient [95% confidence interval], 0.04 [0.02–0.06] points; both P<0.001) level, but not ARVSBP or ARVDBP, was associated with change in global cognitive z scores from visits 4 to 5. Conclusions Greater visit‐to‐visit SBP or DBP variability from midlife on is modestly associated with lower cognitive function, whereas higher mean SBP and lower DBP levels from midlife to later life are modestly associated with cognitive decline in later life.https://www.ahajournals.org/doi/10.1161/JAHA.118.009578blood pressureblood pressure variabilitycognition |
| spellingShingle | Yuichiro Yano Michael Griswold Wanmei Wang Philip Greenland Donald M. Lloyd‐Jones Gerardo Heiss Rebecca F. Gottesman Thomas H. Mosley Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease blood pressure blood pressure variability cognition |
| title | Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study |
| title_full | Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study |
| title_fullStr | Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study |
| title_full_unstemmed | Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study |
| title_short | Long‐Term Blood Pressure Level and Variability From Midlife to Later Life and Subsequent Cognitive Change: The ARIC Neurocognitive Study |
| title_sort | long term blood pressure level and variability from midlife to later life and subsequent cognitive change the aric neurocognitive study |
| topic | blood pressure blood pressure variability cognition |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.009578 |
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