Hypertension, Dietary Sodium, and Cognitive Decline: Results From the Women’s Health Initiative Memory Study

Haring, Bernhard; Wu, Chunyuan; Coker, Laura H.; Seth, Arjun; Snetselaar, Linda; Manson, JoAnn E.; Rossouw, Jacques E.; Wassertheil‐Smoller, Sylvia

doi:10.1093/ajh/hpv081

Cited by 51 publications

(75 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Though cognition may be affected by hypertension through increased risk for stroke and subsequent post-stroke cognitive decline (Ihle-Hansen et al, 2015), hypertension appears to also have a distinct association with cognitive decline independent of stroke incidence. For example, Haring et al(Haring et al, 2015) recently reported findings from over 6,000 women aged 65-79 indicating that hypertension was associated with an increased risk of MCI or probable dementia (HR = 1.20) and risk was highest among those with blood pressure ≥ 140/90 (HR = 1.30; Figure 4). Though the biologic source of such associations has not been completely refined, the relationship is thought by many to center around the development of “vascular dementia” whereby age- and hypertension-related changes in the cerebral vasculature impair cerebral perfusion and induce tissue damage – particularly in the white matter (Kim et al, 2015; McEvoy et al, 2015).…”

Section: Collateral Health Risks Among Older Adults With Hypertensionmentioning

confidence: 99%

“…obesity, insulin resistance) are thought to contribute to dementia development largely through the processes of the Vascular Health Triad (Freeman et al, 2014) possibly resulting in disruption of the blood-brain barrier (Hsu and Kanoski, 2014). Other studies have proposed potential roles for intake of dietary sodium (Fiocco et al, 2012; Haring et al, 2015) and antioxidants (Crichton et al, 2013), though these links are yet to be firmly substantiated. Still, several studies have reported that diets commonly recommended for hypertensive individuals – including a Mediterranean-style diet and the Dietary Approach to Stop Hypertension (DASH) diet – are associated with improved cognition and potential reductions in the incidences of MCI and dementia (Alles et al, 2012; Singh et al, 2014; Wengreen et al, 2013).…”

Section: Collateral Health Risks Among Older Adults With Hypertensionmentioning

confidence: 99%

“…Panel B): Risk of developing MCI or dementia over a mean follow-up of 9.1 years among 6,426 women aged 65-79 years. Created from data in Table 1 of Haring et al(Haring et al, 2015). Hazard ratio (HR) indicates risk of experiencing MCI/dementia compared to normotensive individuals where each 0.1 increase in HR indicates a 10% increase in risk.…”

Section: Figurementioning

confidence: 99%

See 2 more Smart Citations

Hypertension and aging

Buford

2016

Ageing Research Reviews

378

279

View full text Add to dashboard Cite

Hypertension is a highly prevalent condition with numerous health risks, and the incidence of hypertension is greatest among older adults. Traditional discussions of hypertension have largely focused on the risks for cardiovascular disease and associated events. However, there are a number of collateral effects, including risks for dementia, physical disability, and falls/fractures which are increasingly garnering attention in the hypertension literature. Several key mechanisms – including inflammation, oxidative stress, and endothelial dysfunction – are common to biologic aging and hypertension development and appear to have key mechanistic roles in the development of the cardiovascular and collateral risks of late-life hypertension. The objective of the present review is to highlight the multi-dimensional risks of hypertension among older adults and discuss potential strategies for treatment and future areas of research for improving overall care for older adults with hypertension.

show abstract

Section: Collateral Health Risks Among Older Adults With Hypertensionmentioning

confidence: 99%

Section: Collateral Health Risks Among Older Adults With Hypertensionmentioning

confidence: 99%

See 1 more Smart Citation

Hypertension and aging

Buford

2016

Ageing Research Reviews

378

279

View full text Add to dashboard Cite

show abstract

“…As the population ages, identifying modifiable lifestyle factors that promote healthy cognitive aging is an increasingly pressing public health concern (2). Dietary sodium intake is one lifestyle factor that may affect cognitive function (3, 4), but its role in cognitive aging has not been thoroughly studied (5, 6). …”

Section: Introductionmentioning

confidence: 99%

Association between dietary sodium intake and cognitive function in older adults

Rush

Kritz‐Silverstein

Laughlin

et al. 2017

The Journal of nutrition, health and aging

View full text Add to dashboard Cite

OBJECTIVES To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. DESIGN Cross-sectional study SETTING Southern California community PARTICIPANTS White men (n=373) and women (n=552), aged 50–96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. MEASUREMENTS During the 1992–1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. RESULTS Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). CONCLUSION Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets.

show abstract

“…Results of a cognitive function substudy are eagerly awaited as observational studies suggest a U-shaped relationship between BP and cognitive impairment. Some studies show clear benefits from lowering BP in those with systolic BP >140 mm Hg, 12 whereas others suggest potential harm with reductions below 126 to 128 mmHg 13,14 and diastolic BP below 70 mm Hg. 13 Data from the 2007 to 2012 National Health and Nutrition Examination Survey suggest that 7.6% of the US population meet the SPRINT eligibility criteria, which equates to >16 million people.…”

Section: Review Of Sprint Trial 1693mentioning

confidence: 99%

Review of the Systolic Blood Pressure Intervention Trial for Hypertension Management

Silver

Anderson

2016

Stroke

View full text Add to dashboard Cite

O ne of the great successes of modern medicine is the development of effective pharmacological treatments to lower blood pressure (BP). Of the modifiable risk factors for cardiovascular disease, elevated BP or hypertension has the highest population attributable risk, 1 and a near continuous relationship with rates of stroke and coronary heart disease from levels of 115 mm Hg systolic and 75 mm Hg diastolic BP.2 Overviews of randomized trials are consistent in showing that lowering systolic BP by 5 to 10 mm Hg reduces the risk of stroke by one third, irrespective of disease history, initial BP level, or type of agent used.3-5 Moreover, more intensive longterm BP lowering can result in additional benefits proportional to the size of fall in BP. [4][5][6] Despite this body of evidence, there has been longstanding controversy (and consternation) over the levels to which BP should be brought down by treatment for the prevention of cardiovascular disease. Because there has been limited randomized evidence, guideline committees have been challenged in defining BP targets below 130 to 140 mm Hg to manage individual patients.7 Concerns over diminishing net benefit being overtaking by excessive harm with increasing reductions in BP is supported by a physiological argument over critical thresholds for organ perfusion and secondary analysis of randomized trials suggesting a J-shaped relationship with cardiovascular events.8 Moreover, recent trials of more intensive BP lowering, including the Action to Control Cardiovascular Risk on Type 2 Diabetes (ACCORD) 9 and Secondary Prevention of Small Subcortical Strokes (SPS3), 10 failed to show significant reductions in rates of ischemic stroke with systolic BP reductions below 120 and 130 mm Hg, respectively.The main result of the Systolic Blood Pressure Intervention Trial (SPRINT) 11 has, therefore, created a new paradigm in hypertension management and is affecting on hypertension management guidelines around the world. The headline summary was that people at high cardiovascular risk who received more intensive BP-lowering treatment to target systolic levels below 120 mm Hg had fewer cardiovascular events than those who were treated to a target of below 140 mm Hg. For stroke physicians, the key question is whether these results apply to their patients.SPRINT was a carefully conducted clinical trial, sponsored by the National Heart, Lung and Blood Institute of the United States, that involved 9361 hypertensive patients (mean age, 68 years) who were treated to 2 systolic BP treatment targets (<120 versus <140 mm Hg). The key inclusion criteria were an age ≥50 years, systolic BP of 130 to 180 mm Hg, and evidence of increased cardiovascular risk based on either a 10-year Framingham risk estimate of at least 15% or markers of vascular disease including chronic renal disease in approximately one third of participants; but people with diabetes mellitus or stroke were specifically excluded. The study was stopped earlier than planned after a mean follow-up of 3.26 years, on the recommend...

show abstract

Hypertension, Dietary Sodium, and Cognitive Decline: Results From the Women’s Health Initiative Memory Study

Abstract: http://www.clinicaltrials.gov. Unique identifier: NCT00685009 and NCT00745056.

Cited by 51 publications

References 37 publications

Hypertension and aging

Hypertension and aging

Association between dietary sodium intake and cognitive function in older adults

Review of the Systolic Blood Pressure Intervention Trial for Hypertension Management

Contact Info

Product

Resources

About