A study links fluctuating blood pressure to cognitive decline in Black older adults, equating to nearly three years of cognitive aging.
Older adults experiencing fluctuations in blood pressure over time may face a higher risk of difficulties with thinking and memory, according to a study published on December 11, 2024, in Neurology, the medical journal of the American Academy of Neurology. The findings revealed this association among Black participants but not white participants.
It’s important to note that the study does not establish a cause-and-effect relationship between blood pressure variability and cognitive problems; it only identifies a correlation.
“These results suggest that fluctuation in blood pressure is a risk factor for cognitive problems beyond the negative effects of high blood pressure itself,” said study author Anisa Dhana, MD, MSc, of Rush University in Chicago. “Older adults should be routinely monitored for their blood pressure and any changes over time so we can identify people who may have this issue and work to alleviate it, which could potentially help to prevent or delay cognitive problems.”
Study Details and Participant Analysis
The study involved 4,770 people with an average age of 71; 66% were Black participants, and the remaining were white participants.
Participants had blood pressure tests at the beginning of the study and then every three years for an average of 10 years. They also completed thinking and memory skills tests at the beginning and at their last visit.
Overall, the participants had an average blood pressure of 138/78 mmHg. High blood pressure is defined as 130/80 mmHg and higher.
Cognitive Impact of Blood Pressure Variability
Black participants in the study had an average variation over time in their systolic blood pressure, which is the top number, of 18 mmHg, compared to 16 mmHg for white participants.
The participants were divided into three groups based on how much their blood pressure varied over time. For Black participants, those with the most variability in their blood pressure had lower scores on the cognitive tests than those with the least variability. The difference in scores was the equivalent of 2.8 years of cognitive aging.
For people taking blood pressure medications at the start of the study, there was no difference in scores on thinking tests at the end of the study among the groups with high and low blood pressure variation.
“With our aging society and the prevalence of Alzheimer’s disease, identifying prevention strategies to slow the decline of cognitive skills in older adults has become a public health priority,” Dhana said. “Managing blood pressure and its fluctuations is emerging as an essential risk factor that can be modified.”
A limitation of the study is that participants were Black and white people, so the results may not apply to people of other races.
Reference: “Blood Pressure Variability and Cognition in Black and White Older Adults Over 18 Years of Follow-upA Population-Based Cohort Study” by Anisa Dhana, Charles S. DeCarli, Klodian Dhana, Pankaja Desai, Denis A. Evans and Kumar B. Rajan, 11 December 2024, Neurology.
DOI: 10.1212/WNL.0000000000210151
The study was supported by the National Institute on Aging and the Alzheimer’s Association.
