Orthostatic Hypotension Is Associated With Lower Cognitive Performance in Adults Aged 50 Plus With Supine Hypertension

Frewen, John; Finucane, Ciarán; Savva, George M.; Boyle, Gerry; Kenny, Rose Anne

doi:10.1093/gerona/glt171

Cited by 63 publications

(45 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…One study reported an association between OH and cognitive state only if the OH was related to high supine blood pressure [34] and another study reported an association between OH and cognitive state if baseline blood pressure was low. [28] In light of these reports we performed an additional analysis of delta MMSE and diagnoses of cognitive impairment with the patients assigned to one group with supine systolic BP < 140 mm Hg and a second group with supine systolic BP ≥140 mm Hg.…”

Section: Resultsmentioning

confidence: 99%

The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

2016

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

2016

View full text Add to dashboard Cite

show abstract

“…The literature on the influence of orthostatic changes in BP and cognitive status is limited. In the one study available to date, 33 on a large cohort, a greater drop in systolic and diastolic BP on standing coincided with a worse global cognitive performance. It has been demonstrated that higher systolic and diastolic BP levels are associated with a greater prevalence of severe periventricular and subcortical white matter lesions.…”

Section: Changes In Systolic and Diastolic Orthostatic Blood Pressurementioning

confidence: 96%

Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly

et al. 2016

View full text Add to dashboard Cite

Abstract-We studied a cohort of 1408 older subjects to explore whether postural changes in blood pressure (BP; defined as orthostatic hypo-or hypertension) can predict the onset of cognitive deterioration. Orthostatic hypotension was defined as a drop of 20 mm Hg in systolic or 10 mm Hg in diastolic BP and orthostatic hypertension as a rise of 20 mm Hg in systolic BP. Orthostatic BP values were grouped into quintiles for secondary analyses. Two cognitive assessments were considered:(1) cognitive impairment, that is, Mini-Mental State Examination scores ≤24/30, and (2) cognitive decline (CD), that is, a 3-point decrease in Mini-Mental State Examination score from the baseline to the follow-up. At the baseline, the prevalence of orthostatic hypotension and hypertension was 18.3% and 10.9%, respectively. At the follow-up (4.4±1.2 years), 286 participants were found cognitively impaired and 138 had a CD. Using logistic regression analysis adjusted for potential baseline confounders, participants with orthostatic hypertension were at significantly higher risk of CD (odds ratio =1.50; 95% confidence intervals =1.26-1.78). Neither orthostatic hypotension nor orthostatic hypertension raised the risk of developing a cognitive impairment. Using quintiles of orthostatic BP values, we found that both decreases and increases in systolic and diastolic BP raised the risk of CD, but not of cognitive impairment. In conclusion, we found that orthostatic hypertension predicts the onset of CD, but not of cognitive impairment in the elderly, whereas orthostatic hypotension predicts neither of these conditions. Further studies are needed to confirm our findings. Correspondence to Nicola Veronese, Department of Medicine-DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2-35128, Padova, Italy. E-mail ilmannato@gmail.com or Chiara Curreri, Department of Medicine-DIMED, Geriatrics Division, University of Padova, Via Giustiniani, 2-35128 Padova, Italy. E-mail chiaracurreri@icloud.com Orthostatic Changes in Blood Pressure and Cognitive Status in the ElderlyThe Progetto Veneto Anziani Study Methods Data Source and SubjectsThis work was based on data obtained for the Progetto Veneto Anziani (Pro.V.A.) study, an observational cohort study of communitydwelling subjects aged ≥65 years residing in Camposampiero and Rovigo (2 towns in northern Italy), who were enrolled without any specific exclusion criteria. 16 Baseline visits were conducted between October 1995 and November 1997. To avoid any sampling bias, the initial sample was randomly divided into 3 (Camposampiero) and 4 (Rovigo) mutually exclusive subsets that were balanced for age and sex distribution. A random sample was selected from the first subset, and the remaining subsets were set aside. As part of the sampling strategy, age and sex were stratified to maintain a male-to-female ratio of 2:3, to oversample the oldest subjects and thereby obtain reliable estimates of conditions with low prevalence rates, and to recruit a sizable proportion of disabled individuals. Th...

show abstract

“…Fluctuations in BP associated with autonomic dysfunction, such as orthostatic hypotension, become more prevalent with increasing age and may be associated with cognitive deficits [41,43,44]. Although a number of studies have demonstrated a connection between orthostatic hypotension and cognitive function, with worse performance in the setting of orthostasis [45–48], others have failed to replicate this finding [49–51]. Ambulatory blood pressure measurement (ABPM) has been used in a number of studies to more accurately capture short-term, daily BP variability, which may reflect autonomic dysfunction or increased arterial stiffness, among other etiologies.…”

Section: Hypertension and Cognitive Functionmentioning

confidence: 99%

Defining the Relationship Between Hypertension, Cognitive Decline, and Dementia: a Review

2017

View full text Add to dashboard Cite

Hypertension is a highly prevalent condition which has been established as a risk factor for cardiovascular and cerebrovascular disease. Although the understanding of the relationship between cardiocirculatory dysfunction and brain health has improved significantly over the last several decades, it is still unclear whether hypertension constitutes a potentially treatable risk factor for cognitive decline and dementia. While it is clear that hypertension can affect brain structure and function, recent findings suggest that the associations between blood pressure and brain health are complex and, in many cases, dependent on factors such as age, hypertension chronicity, and antihypertensive medication use. Whereas large epidemiological studies have demonstrated a consistent association between high midlife BP and late-life cognitive decline and incident dementia, associations between late-life blood pressure and cognition have been less consistent. Recent evidence suggests that hypertension may promote alterations in brain structure and function through a process of cerebral vessel remodeling, which can lead to disruptions in cerebral autoregulation, reductions in cerebral perfusion, and limit the brain’s ability to clear potentially harmful proteins such as β-amyloid. The purpose of the current review is to synthesize recent findings from epidemiological, neuroimaging, physiological, genetic, and translational research to provide an overview of what is currently known about the association between blood pressure and cognitive function across the lifespan. In doing so, the current review also discusses the results of recent randomized controlled trials of antihypertensive therapy to reduce cognitive decline, highlights several methodological limitations, and provides recommendations for future clinical trial design.

show abstract

Orthostatic Hypotension Is Associated With Lower Cognitive Performance in Adults Aged 50 Plus With Supine Hypertension

Abstract: In conclusion, individuals with SH (defined as BP > 140/90 mmHg) coupled with OH measured using phasic BP had lower global and executive cognitive performance than those with SH but without OH.

Cited by 63 publications

References 35 publications

The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

The association between orthostatic hypotension and cognitive state among adults 65 years and older who underwent a comprehensive geriatric assessment

Orthostatic Changes in Blood Pressure and Cognitive Status in the Elderly

Defining the Relationship Between Hypertension, Cognitive Decline, and Dementia: a Review

Contact Info

Product

Resources

About