Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population

Oishi, Emi; Ohara, Tomoyuki; Sakata, Satoko; Fukuhara, Mikio; Hata, Jun; Yoshida, Daigo; Shibata, Mao; Ohtsubo, Toshio; Kitazono, Takanari; Kiyohara, Yutaka; Ninomiya, Toshiharu

doi:10.1161/circulationaha.116.025667

Cited by 116 publications

(91 citation statements)

References 41 publications

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“…2 However, it remained unclear whether it is the average blood pressure level or blood pressure variability (BPV) that is responsible for the cognitive decline. In this issue of Circulation, Oishi et al 3 provide new data strengthening the case that BPV is a key driver of the association with subsequent dementia, an effect that may be particularly relevant to AD.…”

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confidence: 99%

“…Oishi et al 3 report findings from a prospective study of 1,674 Japanese patients who were 60 years or older and without baseline dementia. The study assessed the association between home day-to-day BPV and the risk of incident all-cause dementia, VaD, and AD.…”

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confidence: 99%

“…Given the limitations of long-term blood pressure monitoring, the results of Oishi. 3 , based on day-to-day monitoring of blood pressure at home, add considerable strength to the association between higher BPV and dementia. Moreover, the majority of prior studies assessing the relationship between BPV and cognitive decline solely focused on patients' MMSE scores and cognitive testing rather than formal diagnoses of dementia.…”

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confidence: 99%

“…4 Interestingly, chronic hypertension may also promote the brain accumulation of amyloid, 11, 12 a pathological hallmark of AD. In this regard, the novel finding of a lack of association between average blood pressure level increases and AD 3 , raises the possibility that BPV may be more likely to promote AD pathology. However, data linking specifically amyloid accumulation to BPV is presently lacking.…”

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confidence: 99%

“…14 However, a factor mitigating this concern is that the results were unchanged after excluding patients with a dementia diagnosis within 2 years of SBP measurement. 3 …”

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confidence: 99%

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Rollercoaster Blood Pressure

Merkler

Iadecola

2017

Circulation

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confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

“…14 However, a factor mitigating this concern is that the results were unchanged after excluding patients with a dementia diagnosis within 2 years of SBP measurement. 3 …”

mentioning

confidence: 99%

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Rollercoaster Blood Pressure

Merkler

Iadecola

2017

Circulation

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Lower complexity and higher variability in beat‐to‐beat systolic blood pressure are associated with elevated long‐term risk of dementia: The Rotterdam Study

Zhou

Kavousi

et al. 2021

Alzheimer's & Dementia

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Introduction We hypothesized that subclinical disruption in blood pressure (BP) dynamics, captured by lower complexity and higher variability, may contribute to dementia risk, above and beyond BP levels. Methods This prospective cohort study followed 1835 older adults from 1997 to 2016, with BP complexity quantified by sample entropy and BP variability quantified by coefficient of variation using beat‐to‐beat BP measured at baseline. Results Three hundred thirty‐four participants developed dementia over 20 years. Reduced systolic BP (SBP) complexity was associated with a higher risk of dementia (hazard ratio [HR] comparing extreme quintiles: 1.55; 95% confidence interval [CI]: 1.09‐2.20). Higher SBP variability was also associated with a higher risk of dementia (HR comparing extreme quintiles: 1.57; 95% CI: 1.11‐2.22. These findings were observed after adjusting for age, sex, apolipoprotein E (APOE) genotype, mean SBP, and other confounding factors. Discussions Our findings suggest that lower complexity and higher variability of beat‐to‐beat SBP are potential novel risk factors or biomarkers for dementia.

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Tau pathologies mediate the association of blood pressure with cognitive impairment in adults without dementia: The CABLE study

et al. 2021

Alzheimer's & Dementia

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Introduction:This study delineated the interrelationships among blood pressure (BP), cerebrospinal fluid (CSF) core biomarkers of Alzheimer's disease (AD), and cognition. Methods:The linear regression analyses were conducted in 1546 non-demented participants (mean age of 61.58 years, range 40 to 89 years; 40% female; average days of BP measurement, 9.10 days). Mediation analyses with 10,000 bootstrapped iterations were used to explore the mediation effects.Results: A clear age-related pattern of BP was delineated. Mid-life hypertension (especially systolic BP), late-life lower diastolic BP, as well as mid-and late-life higher pulse pressure were associated with cognitive impairment and tau-related biomarkers. BP variability was associated only with cognition but not with CSF biomarkers. Overall, the associations between BP and cognition were partially mediated (proportion: 11% to 30%) by tau pathologies, independently of amyloid pathology.Discussion: Tau pathologies might play important roles in the relationship between BP and cognition, with significant age-and BP-type dependences.

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Day-to-Day Blood Pressure Variability and Risk of Dementia in a General Japanese Elderly Population

Abstract: Supplemental Digital Content is available in the text.

Cited by 116 publications

References 41 publications

Rollercoaster Blood Pressure

Rollercoaster Blood Pressure

Lower complexity and higher variability in beat‐to‐beat systolic blood pressure are associated with elevated long‐term risk of dementia: The Rotterdam Study

Tau pathologies mediate the association of blood pressure with cognitive impairment in adults without dementia: The CABLE study

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