Hypertension in Middle Age May Speed Cognitive Decline
Rebecca F. Gottesman, MD, PhD, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues assessed the association between midlife (age 48–67 years) hypertension and the 20-year change in cognitive performance among 13,476 participants (African-American and white).
The researchers found that, among the 58% of living participants who completed the 20-year cognitive follow-up, baseline hypertension, compared with normal blood pressure (BP), was associated with a significant additional cognitive decline of 0.056 global z score points (95% confidence interval [CI], −0.100–−0.012), while prehypertension was associated with a nonsignificant additional cognitive decline of 0.040 global z score points (95% CI, −0.085–0.005). Participants with hypertension who received antihypertensive agents had less cognitive decline during the study period than untreated participants with hypertension (−0.050 [95% CI, −0.003–−0.097] vs. −0.079 [95% CI, −0.156–−0.002] global z score points). In continuous systolic BP analyses, each 20mmHg increment at baseline was associated with an additional cognitive decline of 0.048 (95% CI, −0.074–−0.022) global z score points in whites and 0.020 (95% CI, −0.026–0.066) global z score points in African-Americans.
"The study provides a unique opportunity to understand the role of raised BP on cognition during a 20-year period," writes the author of an accompanying editorial.
One study author and the editorial author disclosed financial ties to pharmaceutical companies.