High BP at night linked to cerebrovascular disease, memory function

BP that goes up at night — a phenomenon known as “reverse dipping” — may be associated with cerebrovascular disease and memory problems, according to research published in Neurology, the medical journal of the American Academy of Neurology.

“It appears that reverse dipping may amplify the effects of high BP on people’s cerebrovascular health and associated cognitive abilities,” Adam M. Brickman, PhD, associate professor of neuropsychology at Columbia University, said in a press release.

Brickman and colleagues reviewed data collected from 435 participants in a prospective, longitudinal community-based cohort study that evaluated dementia and cognitive aging.

Those included in the study had neuropsychological data, ambulatory BP and MRI results available. Participants had their BP monitored over a 24-hour period using BP measurement devices that took measurements every 15 minutes during the day and every 30 minutes at night.

 

BP that goes up at night — a phenomenon known as “reverse dipping” — may be associated with cerebrovascular disease and memory problems, according to research published in Neurology.

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Among the participants (mean age, 59 years), 59% were hypertensive, 10% were reverse dippers and 40% were nondippers, according to the researchers.

Brickman and colleagues found that reverse dipping, when it occurred with hypertension, was associated with increased periventricular white matter hyperintensity volume — a marker of small vessel cerebrovascular disease — and with lower scores on memory testing.

Periventricular white matter hyperintensity volume was shown to mediate the effect of dipping status and hypertension on memory (beta = 4.1; 95% CI, 8.7 to 0.2), according to the researchers.

The researchers determined that reverse dippers with hypertension had a greater than twofold increase in white matter hyperintensity volume compared with that of other groups evaluated in the study.

In addition, those with high BP and reverse dipping had lower scores on memory tests compared with the other groups evaluated in the study. According to the press release, this was explained, in part, by the differences between groups in hypertension and dipping status.

In the release, Brickman explained that the findings “add to the mounting evidence that shows the importance of vascular risk factors in contributing to memory problems.”

“Longer studies that follow people over time will be needed to determine whether these factors do indeed lead to white matter changes and memory problems, although our initial findings are indeed consistent with this hypothesis,” Brickman said. – by Erin Michael

Disclosure: The authors report no relevant financial disclosures.