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Midlife Hypertensive Status and Cognitive Function 20 Years Later: The S outhall and B rent Revisited Study
Author(s) -
Taylor Clare,
Tillin Therese,
Chaturvedi Nish,
Dewey Michael,
Ferri Cleusa P.,
Hughes Alun,
Prince Martin,
Richards Marcus,
Shah Ajit,
Stewart Robert
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12416
Subject(s) - medicine , evening , ambulatory , blood pressure , prospective cohort study , cohort , logistic regression , ambulatory blood pressure , population , demography , ethnic group , gerontology , cognition , physical therapy , psychiatry , environmental health , physics , astronomy , sociology , anthropology
Objectives To investigate long‐term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later. Design Cohort study. Setting Two areas ( S outhall and B rent) of northwest London. Participants Survey samples of a multiethnic population ( E uropean, A frican C aribbean, S outh A sian) aged 40 to 67 were followed up 20 years later. Measurements Comprehensive cardiovascular assessments were performed at baseline, including measurements of resting blood pressure ( BP ) and, in a subsample, ambulatory BP . At follow‐up, a battery of cognitive assessments was administered, and a composite outcome was derived, with impairment defined as the lowest 10% within each ethnic group. Logistic regression models were used to investigate associations with prior measures of hypertensive status. Results In 1,484 participants at follow‐up, cognitive impairment showed significant U ‐shaped associations with baseline diastolic BP ( DBP ) and mean arterial pressure ( MAP ; strongest for those aged ≥50 at baseline), independent of a range of covariates, but no associations were found with systolic BP or pulse pressure. Cognitive impairment was also associated with antihypertensive medication use and higher evening ambulatory DBP at baseline. No substantial differences in strengths of association were found between ethnic groups. Conclusion Low and high DBP and MAP were associated with cognitive impairment 20 years later. Higher evening DBP on ambulatory monitoring was also associated with greater risk.