Diastolic Blood Pressure Linked to Impaired Cognition

Ten-point rise associated with 7 percent higher odds of impairment in middle-aged and older

31 aug 2009-- Higher diastolic blood pressure (DBP) may be associated with a greater risk of impaired cognitive status in middle-aged and older individuals, according to research published in the Aug. 25 issue of Neurology.

Georgios Tsivgoulis, M.D., of the University of Alabama in Birmingham, and colleagues analyzed data from nearly 20,000 African-American and Caucasian men and women ages 45 years and older with no history of stroke or transient ischemic attack.

The researchers found that higher DBP was associated with impaired cognitive status after adjusting for a variety of factors, including age, sex, race, smoking and diabetes. A 10 mm Hg rise in DBP was associated with 7 percent higher odds of cognitive impairment. Systolic blood pressure (SBP) and pulse pressure were not linked to impaired cognitive status.

"It is intriguing that DBP but not SBP (nor pulse pressure) was independently related to impaired cognitive status in our data set. Experimental studies have shown that small cerebral arterioles, which are influenced profoundly by DBP, undergo vascular atrophy progressively with age. Neuropathologic data indicate that elevated DBP levels accelerate this process and lead to formation of ischemic white matter lesions in subcortical areas of the brain. Moreover, higher DBP levels have been associated with the severity of white matter disease both cross-sectionally and longitudinally in large randomly selected samples from two population-based studies," the authors write.

Several authors reported financial relationships with pharmaceutical companies.

Abstract
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