Blood pressure variability, a warning sign for heart disease and dementia in older adults: Study

Australia: A recent study published in Cerebral Circulation - Cognition and Behavior has highlighted the role of systolic and diastolic blood pressure variability (BPV) as a potential early clinical marker for cognitive impairment in older adults. 

The study by Australian researchers showed that high BPV, independently of the mean blood pressure (BP), is associated with increased arterial stiffness and lower cognitive performance in older adults without clinically relevant cognitive impairment

Lead author Daria Gutteridge, a PhD candidate based in UniSA’s Cognitive Ageing and Impairment Neuroscience Laboratory (CAIN), says it’s well known that high blood pressure is a risk factor for dementia, but little attention is paid to fluctuating blood pressure.

“Clinical treatments focus on hypertension, while ignoring the variability of blood pressure,” Gutteridge says.

“Blood pressure can fluctuate across different time frames-short and long-and this appears to heighten the risk of dementia and blood vessel health.”

To help explore the mechanisms that link BP fluctuations with dementia, UniSA researchers recruited 70 healthy older adults aged 60-80 years, with no signs of dementia or cognitive impairment.

Their blood pressure was monitored, they completed a cognitive test, and their arterial stiffness in the brain and arteries was measured using transcranial doppler sonography and pulse wave analysis.

“We found that higher blood pressure variability within a day, as well as across days, was linked with reduced cognitive performance. We also found that higher blood pressure variations within the systolic BP were linked with higher blood vessel stiffness in the arteries.

“These results indicate that the different types of BP variability likely reflect different underlying biological mechanisms, and that systolic and diastolic blood pressure variation are both important for cognitive functioning in older adults.”

The links were present in older adults without any clinically relevant cognitive impairment, meaning that BP variability could potentially serve as an early clinical marker or treatment target for cognitive impairment, the researchers say.

Reference:

D.S. Gutteridge, P.J. Tully, A.E. Smith, T. Loetscher, H.A. Keage, Cross-sectional associations between short and mid-term blood pressure variability, cognition, and vascular stiffness in older adults, Cerebral Circulation - Cognition and Behavior, https://doi.org/10.1016/j.cccb.2023.100181.