High systolic blood pressure linked to less cognitive decline

  • Streit S & al.
  • Ann Fam Med
  • 1 Mar 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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

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
  • 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 for trend=".35).</li">
  • No association was observed between SBP and daily functioning or QoL for participants with or without antihypertensive therapy.

Limitations

  • Observational design.