Masked Hypertension is Associated With Cognitive Decline in Geriatric Age–Geriatric MASked Hypertension and Cognition (G-MASH-cog) Study

Eşme, Mert; Yavuz, Burcu Balam; Yavuz, Bünyamin; Asil, Serkan; Doğrul, Rana Tuna; Sümer, Fatih; Kılıç, Mustafa; Varan, Hacer Doğan; Sagir, Aykut; Balcı, Cafer; Halil, Meltem; Cankurtaran, Mustafa

doi:10.1093/gerona/glx150

Cited by 8 publications

(6 citation statements)

References 41 publications

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“…Previous research has predominantly looked at the crosssectional association between cognitive function and ambulatory BP. Several studies have found an association between dipping and BP patterns and cognitive impairment (23,24,26,41). In a study of 144 patients (mean age, 6867 years) in Japan, frequency of mild cognitive impairment (3MS) was higher among extreme dippers, nondippers, and reverse dippers when compared with dippers (P50.018).…”

Section: Discussionmentioning

confidence: 98%

Association of 24-Hour Ambulatory Blood Pressure Patterns with Cognitive Function and Physical Functioning in CKD

Ghazi

Yaffe

Tamura

et al. 2020

CJASN

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Background and objectivesHypertension is highly prevalent in patients with CKD as is cognitive impairment and frailty, but the link between them is understudied. Our objective was to determine the association between ambulatory BP patterns, cognitive function, physical function, and frailty among patients with nondialysis-dependent CKD.Design, setting, participants, & measurementsAmbulatory BP readings were obtained on 1502 participants of the Chronic Renal Insufficiency Cohort. We evaluated the following exposures: (1) BP patterns (white coat, masked, sustained versus controlled hypertension) and (2) dipping patterns (reverse, extreme, nondippers versus normal dippers). Outcomes included the following: (1) cognitive impairment scores from the Modified Mini Mental Status Examination of <85, <80, and <75 for participants <65, 65–79, and ≥80 years, respectively; (2) physical function, measured by the short physical performance battery (SPPB), with higher scores (0–12) indicating better functioning; and (3) frailty, measured by meeting three or more of the following criteria: slow gait speed, muscle weakness, low physical activity, exhaustion, and unintentional weight loss. Cognitive function and frailty were assessed at the time of ambulatory BP (baseline) and annually thereafter. SPPB was assessed at baseline logistic and linear regression and Cox discrete models assessed the cross-sectional and longitudinal relationship between dipping and BP patterns and outcomes.ResultsMean age of participants was 63±10 years, 56% were male, and 39% were black. At baseline, 129 participants had cognitive impairment, and 275 were frail. Median SPPB score was 9 (interquartile range, 7–10). At baseline, participants with masked hypertension had 0.41 (95% CI, −0.78 to −0.05) lower SPPB scores compared with those with controlled hypertension in the fully adjusted model. Over 4 years of follow-up, 529 participants had incident frailty, and 207 had incident cognitive impairment. After multivariable adjustment, there was no association between BP or dipping patterns and incident frailty or cognitive impairment.ConclusionsIn patients with CKD, dipping and BP patterns are not associated with incident or prevalent cognitive impairment or prevalent frailty.

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Section: Discussionmentioning

confidence: 98%

Association of 24-Hour Ambulatory Blood Pressure Patterns with Cognitive Function and Physical Functioning in CKD

Ghazi

Yaffe

Tamura

et al. 2020

CJASN

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“…Recent studies in humans have suggested there is a link between endothelial dysfunction and AD pathology (37). Geriatric patients with masked hypertension had significantly lower scores on Mini-Mental State Exam test and Categorical Fluency Test than normotensive patients (41). A large meta-analysis of antihypertensive drug therapies shows convincingly that reduction of elevated BP is associated with a substantial reduction in the risk of dementia (133).…”

Section: Adverse Effects Of Estrogen Loss Hypertension and Cvd On Cognition And Progression To Dementiamentioning

confidence: 99%

A heartfelt message, estrogen replacement therapy: use it or lose it

Speth

D'Ambra

et al. 2018

American Journal of Physiology-Heart and Circulatory Physiology

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The issue of cardiovascular and cognitive health in women is complex. During the premenopausal phase of life women have healthy blood pressure (BP) levels that are lower than age-matched men and they have less cardiovascular disease. However, in the post-menopausal stage of life women's BP increases and they are increasingly susceptible to cardiovascular disease, cognitive impairments and dementia, exceeding the incidence in men. The major difference between pre- and post-menopausal women is the loss of estrogen. Thus, it seemed logical that post-menopausal estrogen replacement therapy, with or without a progestin, generally referred to as menopausal hormone treatment (MHT), would prevent these adverse sequelae. However, despite initially promising results, a major randomized clinical trial refuted the benefits of MHT leading to it falling from favor. However, reappraisal of this study in the framework of a "Critical Window", or "Timing Hypothesis" has changed our perspective on the benefit to risk ratio of MHT and this review discusses the historical, current and future approaches to MHT.

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“…In this study, DM, HTN, MI, and PVD were revealed as risk factors in multivariable analysis, which supports the vascular risk factor hypothesis in the pathogenesis of cognitive dysfunction. Vascular risk factors, including HTN, DM, coronary artery disease, and PVD increase the risk of cognitive dysfunction [25-28]. Notably, the use of statin or antiplatelet medications was found to decrease the risk for cognitive dysfunction in this study.…”

Section: Discussionmentioning

confidence: 53%

Correlation of Androgen Deprivation Therapy with Cognitive Dysfunction in Patients with Prostate Cancer: A Nationwide Population-Based Study Using the National Health Insurance Service Database

et al. 2019

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Masked Hypertension is Associated With Cognitive Decline in Geriatric Age–Geriatric MASked Hypertension and Cognition (G-MASH-cog) Study

Cited by 8 publications

References 41 publications

Association of 24-Hour Ambulatory Blood Pressure Patterns with Cognitive Function and Physical Functioning in CKD

Association of 24-Hour Ambulatory Blood Pressure Patterns with Cognitive Function and Physical Functioning in CKD

A heartfelt message, estrogen replacement therapy: use it or lose it

Correlation of Androgen Deprivation Therapy with Cognitive Dysfunction in Patients with Prostate Cancer: A Nationwide Population-Based Study Using the National Health Insurance Service Database

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