High baseline systolic blood pressure may be risk factor for dementia cognitive impairment
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Key takeaways:
- Overall, 14% of patients developed cognitive impairment during the study.
- For every systolic and diastolic blood pressure increase of 10 mm Hg, the adjusted HR for incident cognitive impairment increased by 1.13.
Higher baseline systolic blood pressure may be a strong risk factor for dementia and cognitive impairment in patients with chronic kidney disease, according to a recently published study.
“High blood pressure and cognitive impairment are common in adults with chronic kidney disease,” Seda Babroudi, MD, of the William B. Schwartz Division of Nephrology in Boston, and colleagues wrote. “We sought to identify and characterize the relationship among blood pressure, cognitive impairment and severity of decreased kidney function.”
Researchers conducted a longitudinal cohort study that involved 3,048 patients with CKD in the Chronic Renal Insufficiency Cohort Study. Patients had a mean eGFR of 44 mL/min/1.73 m2 and underwent baseline blood pressure measurements and serial cognitive testing for 11 years. Researchers investigated baseline systolic and diastolic blood pressure (SBP) were investigated as exposure variables. The primary outcome was incident cognitive impairment, defined as a decline in Modified Mini-Mental State Examination score of more than one standard deviation below the cohort mean.
Overall, 14% of patients developed cognitive impairment, according to the findings. Results showed a higher baseline SBP was significantly associated with incident cognitive impairment in the subgroup of participants with eGFR above 45 mL/min/1.73 m2 who did not have cognitive impairment at baseline. For every SBP increase of 10 mm Hg, the adjusted HR for incident cognitive impairment increased by 1.13.
The relationship between baseline SBP and incident cognitive impairment was J-shaped, indicating a non-linear relationship. Participants with eGFR less than or equal to 45 mL/min/1.73 m2 did not show this association. Analysis of baseline diastolic blood pressure did not show an association with cognitive impairment.
“Future studies should focus on identifying underlying causative mechanisms that may mediate the observed difference in cognitive impairment risk as a function of blood pressure in the advanced CKD population,” Babroudi and colleagues wrote.
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