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High systolic BP associated with less cognitive decline
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Patients aged 75 years and older who underwent treatment for systolic BP of 130 mm Hg or higher showed less cognitive impairment vs. those with systolic BP of 130 mm Hg or lower, according to findings recently published in Annals of Family Medicine.
“Hypertension trials ... often exclude older, frail patients and those with complex health problems,” Sven Streit, MD, MSc, PhD, of the Institute of Primary Health Care at the University of Bern in Switzerland.
They added that the “generalizability and applicability” of the studies that led the American Heart Association to revise its hypertension guidelines have often been questioned.
Researchers reviewed data from 1,266 patients (average age, 82.4 years) undergoing hypertension treatment from a prospective cohort. These patients were divided into groups based on their systolic BP the year before the study started. The patients were followed for 1 year.
Streit and colleagues found in those patients undergoing hypertension treatment who had systolic BP of less than 130 mm Hg, crude cognitive decline was 0.9 points on the Mini-Mental State Examination. In patients with systolic BP of more than 150 mm Hg, the crude cognitive decline was 0.14 points. Functional, somatic, mental, and/or social health problems magnified this association.
“Our present findings suggest the importance of close blood pressure monitoring for patients undergoing antihypertensive treatment, to maintain optimal cognition especially in those with complex health problems, those for whom we observed the strongest effect,” Streit and colleagues wrote. “More studies should be conducted to examine whether there is a causal relation and to understand the mechanism of the association observed.” – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.