The link between high blood pressure and cognitive decline was long known. However, a recent study suggests that fluctuations in blood pressure over time increase the risk in older adults. The study, published in Neurology, the medical journal of the American Academy of Neurology, found that fluctuations in blood pressure may age the brain faster, and the association was only found in Black participants.
The study, conducted by researchers at Rush University Medical Center and the University of California at Davis, involved 4,770 adults over age 65 from Chicago between 1993 and 2012. Of these, 66% were Black participants, and the remaining were White participants.
“These results suggest that fluctuation in blood pressure is a risk factor for cognitive problems beyond the negative effects of high blood pressure itself. Older adults should be routinely monitored for their blood pressure and any changes over time so we can identify people who may have this issue and work to alleviate it, which could potentially help to prevent or delay cognitive problems,” study author Anisa Dhana, MD, MSc, of Rush University in Chicago said in a statement.
Participants took blood pressure tests at the start of the study and then every three years over an average period of 10 years. They also underwent thinking and memory skills tests at the beginning and during their final visit. In the study, the Black participants showed an average variation of 18 mmHg in their systolic blood pressure, which is the top number, over time, compared to the 16 mmHg for white participants.
The researchers divided the participants into three groups based on how much their blood pressure varied over time. In Black participants, those with the highest variability in blood pressure scored lower on cognitive tests compared to those with the least variability. The difference was the equivalent of 2.8 years of cognitive aging. Also, the participants, who took blood pressure medication at the start of the study showed no difference in scores on thinking tests, at the end, in both the groups with high and low blood pressure variation.
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“With our aging society and the prevalence of Alzheimer’s disease, identifying prevention strategies to slow the decline of cognitive skills in older adults has become a public health priority. Managing blood pressure and its fluctuations is emerging as an essential risk factor that can be modified,” Dhana added.
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