Cognitive decline greater among patients with hypertension

A greater decline in cognition over 20 years was found among people with midlife hypertension, compared with those with normal blood pressure, according to data from the Atherosclerosis Risk in Communities study.

Rebecca F. Gottesman, MD, PhD, of the department of neurology at the Johns Hopkins University School of Medicine, and colleagues evaluated 13,476 patients to determine the effect of blood pressure on cognitive decline.

Patients with hypertension were older, more likely to have diabetes and stroke, and had lower levels of education and baseline cognitive scores compared with those with normal blood pressure.

Over 20 years, there was a greater decrease in cognitive decline among patients with hypertension compared with those without hypertension. Compared with patients with normal blood pressure, patients with hypertension had a 6.5% greater decline in global cognitive scores over the study period.

Patients using medication to treat blood pressure had lower levels of cognitive decline compared with those not on medication.

“Midlife hypertension, by several definitions, and elevated midlife but not late-life systolic blood pressure [SBP] were associated with more cognitive decline during the 20-year ARIC Study,” the researchers wrote. “Greater linear decline is found with higher midlife BP in white than in African-American participants.”

In an accompanying editorial, Philip B. Gorelick, MD, MPH, of Michigan State University College of Human Medicine, wrote that the study adds evidence to support the association between hypertension and cognitive change.

“This study provides a unique opportunity to understand the role of raised [blood pressure] on cognition during a 20-year period,” he wrote.

For more information:

Gorelick PB. JAMA Neurol. 2014;doi:10.1001/jamaneurol.2014.2014.

Gottesman RF. JAMA Neurol. 2014;doi:10.1001/jamaneurol.2014.1646.

Disclosure: See the full study for a complete list of the researchers’ financial disclosures.