A new study highlights the link between visit-to-visit blood pressure variability (BPV) and cognitive decline in older adults, with the strongest effects observed in Black individuals.
The prospective study analysed data from 4,770 participants aged over 65 in the Chicago Health and Aging Project, which spanned nearly two decades (1993–2012). Researchers assessed blood pressure every three years and calculated BPV based on differences between consecutive measurements. Cognitive function was evaluated using standardised tests, with composite scores converted to z-scores.
Findings revealed that higher systolic and diastolic BPV were associated with lower cognitive performance at the study’s conclusion. Participants with the highest systolic BPV (third tertile) scored 0.074 standardised units lower than those with the lowest BPV, equivalent to 1.8 years of cognitive ageing. Among Black individuals, the effect was more pronounced, with a 0.115-unit decline in cognitive scores, or 2.8 years of cognitive ageing.
These disparities suggest race-specific vulnerability, as significant associations were not observed in White participants. Researchers noted that Black individuals had higher mean systolic BPV (17.7 mm Hg) compared with White participants (16.0 mm Hg).
The findings underscore the importance of monitoring BPV as part of routine care for older adults, particularly in Black populations, to mitigate risks of cognitive decline. Regular blood pressure assessments and interventions to stabilise BPV could play a critical role in preserving cognitive health with ageing.
Helena Bradbury, EMJ
Reference
Dhana A et al. Blood pressure variability and cognition in black and white older adults over 18 years of follow-up: A population-based cohort study. Neurology. 2024;104(1):e210151.
