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Background  High blood pressure is thought to contribute to dementia in late life, but our understanding of the relationship between individual differences in blood pressure ( BP ) and cognitive functioning is incomplete. In this study, cognitive performance in nonhypertensive midlife adults was examined as a function of resting  BP  and regional cerebral blood flow ( rCBF ) responses during cognitive testing. We hypothesized that  BP  would be negatively related to cognitive performance and that cognitive performance would also be related to  rCBF  responses within areas related to  BP  control. We explored whether deficits related to systolic  BP  might be explained by  rCBF  responses to mental challenge.    Methods and Results  Healthy midlife participants (n=227) received neuropsychological testing and performed cognitive tasks in a magnetic resonance imaging scanner. A pseudocontinuous arterial spin labeling sequence assessed  rCBF  in brain areas related to  BP  in prior studies. Systolic  BP  was negatively related to 4 of 5 neuropsychological factors (standardized β>0.13): memory, working memory, executive function, and mental efficiency. The  rCBF  in 2 brain regions of interest was similarly related to memory, executive function, and working memory (standardized β>0.17); however,  rCBF  responses did not explain the relationship between resting systolic  BP  and cognitive performance.    Conclusions  Relationships at midlife between prehypertensive levels of systolic  BP  and both cognitive and brain function were modest but suggested the possible value of midlife intervention.

Prehypertensive Blood Pressures and Regional Cerebral Blood Flow Independently Relate to Cognitive Performance in Midlife