Abstract 12267: Visit-to-visit BP Variability And Carotid Artery Atherosclerosis: A Synergetic Impact On Cognitive Dysfunction
Background Recently, visit-to-visit blood pressure (BP) variations (VVV) has been shown to be associated with stroke. However, the relationship between VVV and cognitive function was not clear. In this study, we investigated the relationship of VVV with cognitive function.
Methods We assessed cognitive function using Mini Mental State Examination (MMSE), and performed carotid artery ultrasound in 201 elderly subjects (79.9±6.4 years old, female 75%) with one or more cardiovascular risks (hypertension, diabetes, hyperlipidemia, and smoking). Based on 12 visits (once a month), visit-to-visit BP variability (expressed as standard deviation [SD] and coefficient of variation [CV]; CV=SD/average value over 12 visits ×100 [%]), maximum, minimum, and delta (maximum-minimum) BP were measured.
Results MMSE score was significantly correlated with age (r=-0.34), diabetes mellitus (r=-0.17), low density lipoprotein (LDL) (r=0.18), CV (r=-0.27), minimum (r=0.18) and delta (r=-0.29) in systolic BP (SBP). Low MMSE score (<25) was significantly correlated with age (r=0.33), calcium channel blockade (CCB) use (r=-0.16), LDL (r=-0.15), mean carotid artery intima-media thickness (IMT) (r=0.16), CV (r=0.26), minimum (r=-0.18) and delta (r=0.29) in SBP. In a multiple linear regression analysis, CV (p<0.001) and delta (p<0.001) in SBP had significant negative associations with MMSE score after adjustment for age, diabetes mellitus, LDL level, and average BP level. The CV (p<0.01) and delta (p<0.01) in SBP had significant positive associations with low MMSE score after adjustment for age, CCB use, LDL level, mean IMT, and average BP level. A significant interaction was found between IMT and delta SBP (P<0.05), and that was found between stiffness parameter β and delta SBP (P<0.05) for the low MMSE score.
Conclusion In the high risk elderly, exaggerated visit-to-visit BP fluctuations were significant indicators for cognitive impairment independently of average BP level. Additionally, VVV and carotid artery atherosclerosis might have a synergetic interaction on cognitive dysfunction.
- © 2012 by American Heart Association, Inc.