Cognitive function in very elderly affected by blood pressure variability

Exaggerated blood pressure variability adversely affects cognitive function in patients 80 years of age and older, according to a study presented at the 21st Annual Scientific Meeting of the American Society of Hypertension, according to a press release from the society.

The study presented by Dr. Kenichi Sakakura (Public Kiwa Clinic, Kumano, Japan) measured blood pressure and cognitive function in 101 Japanese outpatients receiving treatment for chronic diseases, including hypertension, hyperlipidemia, diabetes, chronic gastritis, and osteoporosis. The study sought to evaluate the association between pulse pressure and cognitive function in the very elderly. 24-hour blood pressure monitoring was used and cognitive function was evaluated using the Mini-Mental State Examination (MMSE).

Key results were a 24-h systolic blood pressure of 138.1+17.6 mmHg and a 24-h diastolic blood pressure of 75.9+8.0 mmHg. The mean MMSE score was 23.1 ± 4.2, with 55.4% of patients diagnosed with cognitive dysfunction (<24 points).  MMSE scores decreased across the tertiles of standard deviation of systolic blood pressure readings (P=0.02), indicating lower functioning, but remained significant after controlling for daytime systolic blood pressure  levels, confirming an independent relationship between exaggerated blood pressure variability and cognitive dysfunction in the elderly. 

“Although clinicians may be reluctant to treat older patients aggressively, perhaps because of perceived lower benefits or possible increased risk of medication side effects, these findings show the potential value of interventions. These results further validate previous indications that variable blood pressure has an effect on cognitive function in the very elderly.  However, very little data exists to support these theories, and more research is needed to confirm the full impact of blood pressure on cognitive function in these patients,” Sakakura stated.