Association between Pulse Pressure and Onset of Dementia in an Elderly Korean Population: A Cohort Study

Abstract

Objective: There is paucity of studies on the association between pulse pressure and the development of dementia, although this association has already been established. This study aimed at investigating the association between pulse pressure and the onset of dementia. Methods: We used the South Korean National Health Insurance Service claims cohort data to select 149,663 patients without dementia aged ≥60 years. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia using Cox proportional hazard models according to a pulse pressure classification (<50, 50-59, 60-69, 70-79, 80-89, or 90+). Results: Compared to women with pulse pressure <50, those with pulse pressures of 50-59, 60-69, and 90+ had higher HRs for dementia (1.14, 1.22, and 1.03, respectively). These associations were particularly strong in those on Medicaid insurance and from rural regions. However, there were no statistically significant results among men. Conclusions: A higher pulse pressure was associated with an elevated risk of dementia in women aged >60 years, particularly those on Medicaid and from rural regions, possibly due to their inability to access hypertension and other medical treatment. The establishment of dementia indicators will help to guide future health policies for the prevention of dementia.

Elevated pulse pressure and its associations with demographic and clinical parameters in a clinically representative sample of outpatients with psychotic disorders

“…Patients in employment tend to have better financial situations, and this might influence their opportunity to access treatment for hypertension and other medical conditions, as observed in previous studies. 8,14 Blood pressure is regularly measured in psychiatric settings, and pulse pressure is easily calculated. It is therefore worth considering using pulse pressure more actively as a prognostic marker in clinical practice.…”

“…Patients in employment tend to have better financial situations, and this might influence their opportunity to access treatment for hypertension and other medical conditions, as observed in previous studies. 8,14…”

“…Furthermore, examining associations with demographic and clinical characteristics could help to identify patients at increased risk of elevated pulse pressure, such as those with reduced access to blood pressure screenings due to their socioeconomic status and functional impairments. 8,9 We therefore aimed to examine pulse pressure and its associations with demographic and clinical characteristics, and with several domains of functioning among outpatients with psychotic disorders.…”

“…Furthermore, examining associations with demographic and clinical characteristics could help to identify patients at increased risk of elevated pulse pressure, such as those with reduced access to blood pressure screenings due to their socioeconomic status and functional impairments. 8,9…”

Association between depression and the risk of Alzheimer’s disease using the Korean National Health Insurance Service-Elderly Cohort

“…Several studies have focused on early detection and intervention for cognitive decline, to alleviate the financial and public health impact of the surge in the incidence of dementia 9 . Other studies have focused on ascertaining the conditions associated with the incidence of dementia, that is, preventing dementia by impeding the occurrence of associated conditions, such as hypertension and diabetes 10 – 12 . The subtypes of dementia should also be considered for prevention due to their difference in etiology 13 , 14 .…”