Is fluctuating blood pressure a sign of future dementia and heart disease?

A new study by Australian researchers has shown that fluctuating blood pressure can increase the risk of dementia and vascular problems in older people. Short blood pressure (BP) fluctuations within 24 hours as well as over several days or weeks are linked with impaired cognition, say University of South Australia (UniSA) researchers who led the study. Higher systolic BP variations are also linked with stiffening of the arteries, associated with heart disease. The findings have been published in the journal Cerebral Circulation – Cognition and Behaviour.

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.

The researchers said that they found that higher blood pressure variability within a day, as well as across days, was linked with reduced cognitive performance. They 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.

Reference: Cross-sectional associations between short and mid-term blood pressure variability, cognition, and vascular stiffness in older adults,Cerebral Circulation - Cognition and Behavior

DOI: 10.1016/j.cccb.2023.100181