Spectral analyses of systolic blood pressure and heart rate variability and their association with cognitive performance in elderly hypertensive subjects

Abstract

Systolic hypertension is associated with cognitive decline in the elderly. Altered blood pressure (BP) variability is a possible mechanism of reduced cognitive performance in elderly hypertensives. We hypothesized that altered beat-to-beat systolic BP variability is associated with reduced global cognitive performance in elderly hypertensive subjects. In exploratory analyses, we also studied the correlation between diverse discrete cognitive domains and indices of systolic BP and heart rate variability. Disproving our initial hypothesis, we have shown that hypertension and low education, but not indices of systolic BP and heart rate variability, were independent predictors of lower global cognitive performance. However, exploratory analyses showed that the systolic BP variability in semi-upright position was an independent predictor of matrix reasoning (B = 0.08 ± .03, P-value = 0.005), whereas heart rate variability in semi-upright position was an independent predictor of the executive function score (B = -6.36 ± 2.55, P-value = 0.02). We conclude that myogenic vascular and sympathetic modulation of systolic BP do not contribute to reduced global cognitive performance in treated hypertensive subjects. Nevertheless, our results suggest that both systolic BP and heart rate variability might be associated with modulation of frontal lobe cognitive domains, such as executive function and matrix reasoning.

Cardiac Autonomic Modulation Behavior in Community Men with Hypertension on rest and Effort Condition

“…The values found in the frequency domain, despite also presenting reduction, after the statistical analysis showed no statistical significance. The analysis of the indices of HRV performed in the present study observed reduction of their indices in hypertensive individuals after the completion of the TC6, corroborating studies found in the literature [13][14][15][20][21][22][23] that analyzed this population in similar conditions. The reduction of the indices pNN50 and rMSSD reflect the parasympathetic modulation found in hypertensive patients studied and are in accordance with what is observed in the literature.…”

“…The reduction of the indices pNN50 and rMSSD reflect the parasympathetic modulation found in hypertensive patients studied and are in accordance with what is observed in the literature. Huikuri 22 upon comparing normotensive and hypertensive male subjects and mean age of 50 years, found reduced values in both areas, concluding that long-time hypertensive patients, have alteration in their autonomic modulation, reflecting on the HRV. Result also found in another comparative study of the HRV in hypertensive patients, with the same distribution of age and sex as their control group 13 .…”

Association Between Blood Pressure Variability With Dementia and Cognitive Impairment: A Systematic Review and Meta-Analysis

“…Reasons for exclusion after full-text review are described in Table S1 in the Data Supplement. 32–51 Twenty unique studies samples met the inclusion criteria for the primary outcome (analytical n=7 899 679). 52–71 These comprised 8 cohort studies (n=18 067), 2 nested cohort studies (n=698), one nationwide registry database (n=7 844 814), 4 randomized controlled trials analyzed as a cohort (n=32 684), 3 cross-sectional studies (n=3006), and 2 case-control studies (n=410).…”

Hypertension and Its Role in Cognitive Function: Current Evidence and Challenges for the Future

“…These include intervisit BP variability, [84][85][86] orthostatic intolerance, 87 and heart rate variability. 88 In particular, intervisit variability in BP is emerging as an important marker of dyshomeostasis in innate BP control with initial studies suggesting that variability in SBP over time is associated with greater atrophy, a higher rate of cortical atrophy and thinning, 84 global cognitive dysfunction, 85,86 and worse psychomotor speed and verbal memory. 86 The importance of assessing pulsatile flow from the heart to the brain As a result of its extensive microvasculature, the brain is a high flow, low resistance organ that is continuously exposed to the mechanical forces of cardiac pulsations.…”