scholarly journals Systolic Blood Pressure and Cognitive Decline in Older Adults With Hypertension

2019 ◽  
Vol 17 (2) ◽  
pp. 100-107 ◽  
Author(s):  
Sven Streit ◽  
Rosalinde K.E. Poortvliet ◽  
Wendy P.J. den Elzen ◽  
Jeanet W. Blom ◽  
Jacobijn Gussekloo
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Decline ◽  
Systolic Blood Pressure

scholarly journals Time‐Efficient Inspiratory Muscle Strength Training Lowers Blood Pressure and Improves Endothelial Function, NO Bioavailability, and Oxidative Stress in Midlife/Older Adults With Above‐Normal Blood Pressure

2021 ◽  
Author(s):  
Daniel H. Craighead ◽  
Thomas C. Heinbockel ◽  
Kaitlin A. Freeberg ◽  
Matthew J. Rossman ◽  
Rachel A. Jackman ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Muscle Strength ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Systolic Blood Pressure ◽  
High Resistance ◽  
Maximal Inspiratory Pressure ◽  
No Bioavailability ◽  
Inspiratory Muscle Strength

Background High‐resistance inspiratory muscle strength training (IMST) is a novel, time‐efficient physical training modality. Methods and Results We performed a double‐blind, randomized, sham‐controlled trial to investigate whether 6 weeks of IMST (30 breaths/day, 6 days/week) improves blood pressure, endothelial function, and arterial stiffness in midlife/older adults (aged 50–79 years) with systolic blood pressure ≥120 mm Hg, while also investigating potential mechanisms and long‐lasting effects. Thirty‐six participants completed high‐resistance IMST (75% maximal inspiratory pressure, n=18) or low‐resistance sham training (15% maximal inspiratory pressure, n=18). IMST was safe, well tolerated, and had excellent adherence (≈95% of training sessions completed). Casual systolic blood pressure decreased from 135±2 mm Hg to 126±3 mm Hg ( P <0.01) with IMST, which was ≈75% sustained 6 weeks after IMST ( P <0.01), whereas IMST modestly decreased casual diastolic blood pressure (79±2 mm Hg to 77±2 mm Hg, P =0.03); blood pressure was unaffected by sham training (all P >0.05). Twenty‐four hour systolic blood pressure was lower after IMST versus sham training ( P =0.01). Brachial artery flow‐mediated dilation improved ≈45% with IMST ( P <0.01) but was unchanged with sham training ( P =0.73). Human umbilical vein endothelial cells cultured with subject serum sampled after versus before IMST exhibited increased NO bioavailability, greater endothelial NO synthase activation, and lower reactive oxygen species bioactivity ( P <0.05). IMST decreased C‐reactive protein ( P =0.05) and altered select circulating metabolites (targeted plasma metabolomics) associated with cardiovascular function. Neither IMST nor sham training influenced arterial stiffness ( P >0.05). Conclusions High‐resistance IMST is a safe, highly adherable lifestyle intervention for improving blood pressure and endothelial function in midlife/older adults with above‐normal initial systolic blood pressure. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03266510.

Abstract 22: Visit-to-Visit Variability in Blood Pressure is Related to Late-Life Cognitive Decline

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Bo Qin ◽  
Anthony J Viera ◽  
Linda S Adair ◽  
Brenda L Plassman ◽  
Lloyd J Edwards ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Nutrition Survey

Introduction: Recent studies suggest higher visit-to-visit variability of blood pressure (BP) is associated with worse cognitive function, but evidence based on longitudinal cognitive testing has not been reported. Hypothesis: We assessed the hypothesis that higher visit-to-visit variability in BP, but not mean BP, would be associated with faster decline in cognitive function among community-dwelling older adults. Methods: This prospective cohort study comprised 1213 adults who had two or more waves of BP measurements as part of the China Health and Nutrition Survey from 1991, up to their first cognitive tests, and completed a cognitive screening test at two or more waves in 1997, 2000 or 2004. Mean (SD) age at first cognitive test was 64 (6) y. Outcomes were repeated measures of global cognitive scores (baseline mean ± SD: 19 ± 6 points), standardized composite cognitive and verbal memory scores (standardized units [SU]). Visit-to visit BP variability was expressed as the standard deviation [SD] or as the variation independent of mean (SD/mean^x, with x derived from curve fitting) in BP measures obtained at a mean interval of 3.6 years. Multivariable-adjusted linear mixed-effects models were used to determine the association of changes in cognitive scores with visit-to visit BP variability. Results: Higher visit-to-visit variability in systolic BP, but not mean systolic BP, was associated with a faster decline of cognitive function (adjusted mean difference [95% CI] for high vs. low tertile of SD in variability (Figure): global score -0.23 points/y [-0.41 to -0.04], composite scores -0.029 SU/y [-0.056 to -0.002] and verbal memory -0.044 SU/y [-0.075 to -0.012]). Higher visit-to-visit variability in diastolic BP was associated with a faster decline of global cognitive function only among adults 55-64 years, independent of mean diastolic BP. Conclusion: Higher long-term BP visit-to-visit variability predicted a faster rate of cognitive decline among older adults.

scholarly journals Heterogeneous Exposure Associations in Observational Cohort Studies: The Example of Blood Pressure in Older Adults

2019 ◽  
Vol 189 (1) ◽  
pp. 55-67
Author(s):  
Michelle C Odden ◽  
Andreea M Rawlings ◽  
Abtin Khodadadi ◽  
Xiaoli Fern ◽  
Michael G Shlipak ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Confidence Interval ◽  
Systolic Blood Pressure ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Creatinine Concentration ◽  
Body Composition Study ◽  
Health Aging

Abstract Heterogeneous exposure associations (HEAs) can be defined as differences in the association of an exposure with an outcome among subgroups that differ by a set of characteristics. In this article, we intend to foster discussion of HEAs in the epidemiologic literature and present a variant of the random forest algorithm that can be used to identify HEAs. We demonstrate the use of this algorithm in the setting of the association between systolic blood pressure and death in older adults. The training set included pooled data from the baseline examination of the Cardiovascular Health Study (1989–1993), the Health, Aging, and Body Composition Study (1997–1998), and the Sacramento Area Latino Study on Aging (1998–1999). The test set included data from the National Health and Nutrition Examination Survey (1999–2002). The hazard ratios ranged from 1.25 (95% confidence interval: 1.13, 1.37) per 10-mm Hg increase in systolic blood pressure among men aged ≤67 years with diastolic blood pressure greater than 80 mm Hg to 1.00 (95% confidence interval: 0.96, 1.03) among women with creatinine concentration ≤0.7 mg/dL and a history of hypertension. HEAs have the potential to improve our understanding of disease mechanisms in diverse populations and guide the design of randomized controlled trials to control exposures in heterogeneous populations.

scholarly journals DOES GENDER INFLUENCE RISK FOR ORTHOSTATIC HYPOTENSION IN OLDER ADULTS WITH SARCOPENIA?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S682-S682
Author(s):  
Melissa J Benton ◽  
Amy L Silva-Smith ◽  
Jefferson M Spicher
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Systolic Blood Pressure ◽  
Orthostatic Hypotension ◽  
Lean Mass ◽  
Bioelectrical Impedance ◽  
Early Morning ◽  
Postural Changes ◽  
Before And After ◽  
Pressure Changes

Abstract Older adults with sarcopenia may be at risk for unstable postural blood pressure due to diminished lean mass that plays a role in maintaining fluid volume. Males have greater lean mass, so risk may be mediated by gender. We compared postural blood pressure changes in older men (77.1 ± 2.0 years; n = 15) and women (79.6 ± 2.0 years; n = 13) with sarcopenia before and after an overnight fast. Sarcopenia was defined using the Lean Mass Index (males ≤ 19.0 kg/m2; females ≤ 15.0 kg/m2). Body composition was measured using multi-frequency bioelectrical impedance, and blood pressure was measured lying, sitting, and standing. On Day 1 (normally hydrated) there were significant drops in systolic blood pressure, with an overall decrease of -9.1 ± 2.2 mmHg (p &lt; 0.001) between lying and standing. On Day 2 (overnight fast), postural changes were more profound, with an overall decrease of -14.1 ± 2.8 mmHg (p &lt; 0.001). However, when compared by gender, postural changes between lying and standing remained significant but did not differ between men and women (Day 1: men -8.9 ± 2.5 vs. women -9.3 ± 2.5 mmHg; Day 2: men -14.6 ± 4.6 vs. women -13.6 ± 3.1 mmHg). On both days diastolic blood pressure remained stable. In this group of older adults, significant decreases in postural systolic blood pressure were observed in the early morning fasted condition, increasing the risk for orthostatic hypotension (drop in systolic blood pressure -20.0 mmHg). Interestingly, gender did not influence risk.

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