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Visit-To-Visit Blood Pressure Variability and the Risk of Dementia in Older People.
- Source :
- Journal of Alzheimer's Disease; 2018, Vol. 62 Issue 2, p727-735, 9p
- Publication Year :
- 2018
-
Abstract
- <bold>Background: </bold>High visit-to-visit variability (VVV) in blood pressure (BP) is associated with cerebrovascular lesions on neuroimaging.<bold>Objective: </bold>Our primary objective was to investigate whether VVV is associated with incident all-cause dementia. As a secondary objective, we studied the association of VVV with cognitive decline and cardiovascular disease (CVD).<bold>Methods: </bold>We included community-dwelling people (age 70-78 year) from the 'Prevention of Dementia by Intensive Vascular Care' (preDIVA) trial with three to five 2-yearly BP measurements during 6-8 years follow-up. VVV was defined using coefficient of variation (CV; SD/mean×100). Cognitive decline was assessed using the Mini-Mental State Examination (MMSE). Incident CVD was defined as myocardial infarction or stroke. We used a Cox proportional hazard regression and mixed-effects model adjusted for sociodemographic factors and cardiovascular risk factors.<bold>Results: </bold>In 2,305 participants (aged 74.2±2.5), mean systolic BP over all available visits was 150.1 mmHg (SD 13.6), yielding a CV of 9.0. After 6.4 years (SD 0.8) follow-up, 110 (4.8%) participants developed dementia and 140 (6.1%) CVD. Higher VVV was not associated with increased risk of dementia (hazard ratio [HR] 1.00 per point CV increase; 95% confidence interval [CI] 0.96-1.05), although the highest quartile of VVV was associated with stronger decline in MMSE (β -0.09, 95% CI -0.17 to -0.01). Higher VVV was associated with incident CVD (HR 1.07; 95% CI 1.04-1.11).<bold>Conclusion: </bold>In our study among older people, high VVV is not associated with incident all-cause dementia. It is associated with decline in MMSE and incident CVD. [ABSTRACT FROM AUTHOR]
- Subjects :
- DEMENTIA risk factors
BLOOD pressure measurement
BLOOD pressure
CARDIOVASCULAR disease diagnosis
COGNITIVE development
ANTIHYPERTENSIVE agents
CARDIOVASCULAR diseases
COMPARATIVE studies
DEMENTIA
HYPERTENSION
RESEARCH methodology
MEDICAL cooperation
QUESTIONNAIRES
RESEARCH
EVALUATION research
DISEASE incidence
PROPORTIONAL hazards models
Subjects
Details
- Language :
- English
- ISSN :
- 13872877
- Volume :
- 62
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Journal of Alzheimer's Disease
- Publication Type :
- Academic Journal
- Accession number :
- 128214321
- Full Text :
- https://doi.org/10.3233/JAD-170757