Blunted reduction in night-time blood pressure is associated with cognitive deterioration in subjects with long-standing hypertension

• Published in: Blood pressure monitoring Vol. 9; no. 2; pp. 71 - 76
• Main Authors: Bellelli, Giuseppe, Frisoni, Giovanni B, Lucchi, Elena, Guerini, Fabio, Geroldi, Cristina, Magnifico, Francesca, Bianchetti, Angelo, Trabucchi, Marco
• Format: Journal Article
• Language: English
• Published: England 01-04-2004
• Subjects: Aged; Aged, 80 and over; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory; Cerebrovascular Disorders - etiology; Circadian Rhythm; Cognition Disorders - etiology; Female; Humans; Hypertension - complications; Male; Multivariate Analysis
• ISSN: 1359-5237
• DOI: 10.1097/00126097-200404000-00003

Data about the relationship of blunted reduction of night-time blood pressure (BP) with cognitive deterioration (CD) are conflicting. This study aims to explore this possible association in elderly people with long-standing hypertension.
Twenty-six hypertensive subjects consecutively admitted to a rehabilitation unit over a six-month period were recruited. Exclusion criteria concerned all clinical conditions potentially related to BP variability or leading to CD. All patients underwent a clinic and 24-h BP non-invasive monitoring assessment of BP, as well as a cognitive assessment with the Mini Mental State Examination (MMSE). The presence of cerebrovascular disease (CVD) was assessed on CT films, with a standardized visual rating scale.
Blunted reduction of both systolic and diastolic night-time BP were significantly associated with poorer cognitive performances (r=0.61, p=0.001 for systolic; and r=0.57, p=0.002 for diastolic, respectively). In a multiple regression model, blunted reduction of night-time BP (B=0.17, [95% confidence intervals: 1.1-1.3], p=0.008 for systolic; and B=0.15, [95% confidence intervals: 1.0-1.3], p=0.02 for diastolic) independently predicted poorer cognitive performances.
In subjects with long-standing hypertension the blunted reduction of night-time BP is independently associated with lower cognitive performances.