Takeaway
- Participants aged ≥75 years who underwent treatment for systolic blood pressure (SBP) of ≥130 mmHg showed less cognitive impairment after 1 year vs those with SBP of <130 mmHg, without loss of daily functioning or quality of life (QoL).
Why this matters
- Findings highlight the importance of close BP monitoring for patients undergoing antihypertensive treatment and suggest that SBP threshold for frail older people should be redefined.
Study design
- This prospective study included 1266 participants (average age, 82.4 years; 874 women) using data from the Integrated Systematic Care for Older Persons (ISCOPE] study.
- Patients were categorised into groups based on their SBP the year prior to study commencement.
- Change from baseline to 1-year follow-up was evaluated in cognitive function (Mini-Mental State Examination [MMSE]), daily functioning (Groningen Activity Restriction Scale [GARS]) and QoL (EQ-5D-3L).
- Funding: ISCOPE study was funded by ZonMw, the Netherlands, Organization for Health Research and Development.
Key results
- For patients undergoing hypertension treatment and who had SBP of <130 mmHg, cognitive decline in 1 year averaged 0.90 (95% CI, 0.43-1.36) points MMSE.
- Whereas for patients with SBP >150 mmHg, the crude cognitive decline was 0.14 (95% CI, 0.21-0.49) points (a 0.76-point less decline; P for trend=.013).
- For participants with complex health problems, same association was found in those undergoing hypertension treatment (P for trend<.001), but not in those without (P for trend=.35).
- No association was observed between SBP and daily functioning or QoL for participants with or without antihypertensive therapy.
Limitations
- Observational design.
References
References