People who experience sustained hypertension in midlife to late life and those who experience midlife hypertension followed by late-life hypotension are at increased risk for dementia vs people who maintain normal blood pressure (BP).
The findings, reported in the August edition of JAMA, “are consistent with previous work that has demonstrated a relationship between chronic hypertension and reduced cognition in older adults,” stated researchers led by Keenan A. Walker, PhD, assistant professor of neurology at Johns Hopkins University School of Medicine.
It is known that hypertension and hypotension can both lead to cognitive decline and dementia. There is a gap in understanding, however, about the effect of BP patterns in the later decades of life on cognitive function and subsequent dementia.
The authors sought to determine if community dwelling adults with extended duration of midlife hypertension followed by hypotension later in life are at higher risk for dementia at an older age.
This community-based cohort study used data from the ongoing Atherosclerosis Risk in Communities study, which has recorded BP information for its cohort over 24 years, including midlife to late life.
The current analysis included all participants who received a baseline cognitive battery and functional assessment at visit 5 (2011-2013). A total of 4761 participants were included in the analytic sample (59% women, 21% black race).
The mean age at visit 5 was 75 years; mean age range at visit 1 was 44-66 years; and mean age range at visit 5 was 66-90 years.
Walker KA, Sharrett AR, Wu A, et al. Association of midlife to late-life blood pressure patterns with incident dementia. JAMA. 2019;322:535-545.