scholarly journals Systolic Blood Pressure and Cognition in the Elderly: The Northern Manhattan Study

2021 ◽  
pp. 1-11
Author(s):  
Xiaoyan Sun ◽  
Chuanhui Dong ◽  
Bonnie Levin ◽  
Michelle Caunca ◽  
Adina Zeki Al Hazzouri ◽  
...  

Background: Increasing evidence suggests that hypertension is a risk factor for cognitive impairment and dementia. The relationship between blood pressure and cognition in a racially and ethnically diverse population remains unclear. Objective: To study association of blood pressure with cognition cross-sectionally and longitudinally in the elderly. Methods: Participants are stroke-free individuals from the racially and ethnically diverse Northern Manhattan Study (NOMAS) (n = 1215). General linear models are constructed to examine blood pressure in relation to cognition cross-sectionally and longitudinally at a five-year follow-up. Results: We found a cross-sectional association of systolic blood pressure (SBP) with word fluency/semantic memory, executive function, and processing speed/visual motor integration (VMI) function. This association was independent of demographics, vascular risk factors, white matter hyperintensity volume (WMHV), and carotid intima-media thickness (cIMT). The cross-sectional association of SBP with processing speed/VMI and executive function was attenuated after adjusting anti-hypertension medications in the models. Baseline SBP was associated with the change of processing speed/VMI function after adjusting vascular risk factors, WMHV, and cIMT at a 5-year follow-up. This longitudinal association was not found after adjusting anti-hypertension medications in the models. Further analyses revealed that individuals with category SBP from <  120 mmHg to≥140 mmHg had a linear decline in processing speed/VMI function at a 5-year follow-up. Conclusion: We show that SBP is negatively associated with cognition cross-sectionally and longitudinally in the elderly. Anti-hypertension treatment eliminates the negative association of SBP with processing speed/VMI function longitudinally. Our findings support the treatment of stage 1 systolic hypertension in the elderly.

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Arkadiusz Siennicki-Lantz ◽  
Sölve Elmståhl

To assess an impact of vascular risk factors on ambulatory blood pressure measurement (ABPM) in the elderly, we followed up a population-based cohort of men from 68 until 82 years, when 104 survivors underwent ABPM.Results. At age 68, hypertension and high clinic blood pressure (CBP) did not predict ABPM level. Smoking and low ankle-brachial index (ABI) predicted higher ABPM variability and pulse pressure (PP), but not absolute ABPM values. At age 82, hypertension, high or increasing CBP, strongly positively correlated with all variables of ABPM. Carotid stenosis, low or declining ABI during followup, correlated with higher nocturnal ABPM and PP.Concluding. Hypertension and vascular risk factors in a cohort of 68-year-old men do not result in higher ABPM at age 82, possibly due to inflection point in their pressure development. Higher ABPM reflects instead an increasing CBP and aggravating atherosclerosis during the preceding decade in that part of the cohort with previously favorable risk factor status.


2019 ◽  
Vol 23 (2) ◽  
Author(s):  
Breno de Sousa Santana ◽  
Bárbara Soares Rodrigues ◽  
Marina Morato Stival ◽  
Cris Renata Grou Volpe

Abstract Objective: to analyze blood pressure control in elderly hypertensives accompanied by a Basic Health Unit of the Federal District, determining the sociodemographic profile and the associated risk factors. Method: this is a cross-sectional study with 133 elderly hypertensive patients. Variables related to sociodemographic factors, life habits, clinical factors and adherence to drug therapy were evaluated through the application of semistructured instruments and validated scales. Results with p <0.05 were considered significant. Results: the elderly presented controlled blood pressure (56.4%) predominantly. The majority of the participants were female and women also had a higher rate of uncontrolled blood pressure (86.2%). Older age was associated with higher blood pressure values (p = 0.031). Alcoholism (p = 0.020) and mean body mass index of 33.0 (p <0.000) were factors associated with hypertension adherence to therapy had more controlled values of systolic and diastolic blood pressure. Conclusion and implications for the practice: it was verified that there is a strong association between the risk factors discussed and the lack of control of the blood pressure of elderly hypertensive, especially with regard to advanced age, alcoholism, obesity and overweight, and it is necessary to reorient the planning and strategies of promotion of health and prevention of diseases directed at the elderly hypertensive in the scope of primary health care.


2003 ◽  
Vol 15 (1) ◽  
pp. 27-36 ◽  
Author(s):  
Robert Stewart ◽  
Jae-Min Kim ◽  
Il-Seon Shin ◽  
Jin-Sang Yoon

Background/Objective: The association between hypertension, diabetes, and worse cognitive function has been reported to be stronger in groups with low levels of education. Using data from a cross-sectional community survey of Korean elders, we sought to investigate this within a sample with relative cognitive impairment. Methods: The sample consisted of 341 participants with Mini-Mental State Examination (MMSE) (Korean version) scores of 24/30 or below. Previous diagnoses were ascertained and participants were examined for resting blood pressure and nonfasting blood glucose and cholesterol. Results: After adjustment for age, occupation, physical dependence, and cholesterol levels, worse cognitive function (MMSE score < 21) within the sample was associated with raised systolic blood pressure, raised glucose levels, and a previous diagnosis of diabetes. These associations were significant only in participants with no formal education. In this group the adjusted odds ratios for worse cognitive function were 1.18 (95% confidence interval [CI] 1.04-1.34) for each 10 mmHg increase in systolic blood pressure and 3.47 (1.14-10.6) for a previous diagnosis of diabetes. Odds ratios for the group with previous education were 0.99 (0.81-1.21) and 1.82 (0.48-6.92), respectively. Conclusion: The association between risk factors for cerebrovascular disease and cognitive impairment appears to be particularly strong in people with lower educational attainment.


Author(s):  
Paulo Renato Carvalho Alonso Rays ◽  
Honório Sampaio Menezes

Resumo: Hipertensão Arterial é definida como elevação da pressão arterial sistólica e diastólica acima de 140/90mmHg, respectivamente. Estima-se que mais de 50% dos pacientes acima de 60 anos tenham hipertensão, o que deixa essa população sob risco aumentado de doenças em órgãos alvo como coração, rins e cérebro, aumentando também a morbimortalidade desta população. Diversos estudos comprovam que a terapia anti-hipertensiva reduz o risco e a morbimortalidade cardiovascular, cerebral e renal. No presente trabalho foi realizado um estudo transversal, observacional, prospectivo, onde foram avaliadas as medidas da pressão arterial de 24 pacientes idosos do grupo de 70 pacientes hipertensos do ambulatório do Programa Saúde da Família da cidade de Mata, interior do RS. Foi utilizada estatística descritiva e distribuição por freqüência, além do teste “t” de Student para comparação de médias, com nível de significância de 5% para análise dos dados. A pressão sistólica variou entre 120 e 180mmHg, a diastólica entre 60 e 100mmHg. Em 17 (70,83%) dos pacientes não houve associação da hipertensão com outra doença crônica, em quatro (16,22%) havia associado diabete melito tipo II e três (12,50%) tinham dislipidemia. Predominou o sexo feminino em 75% (18) dos pacientes estudados. A pressão sistólica estava acima de 140mmHg em 10 (41,67%) dos pacientes entre os quais havia quatro (16,67%) com a diastólica acima de 90mmHg. Dois quintos dos idosos, mesmo sob tratamento ambulatorial, não apresentava controle da hipertensão arterial adequado. Palavras-chave: Hipertensão. Idoso. Controle. Abstract: Hypertension is defined as an elevation of systolic and diastolic blood pressure above 140/90mmHg. More than 50% of patients over 60 years have hypertension, which increases the risk of cerebrovascular, kidney and heart diseases in this population. The anti-hypertensive therapy reduces risks according several studies. This cross sectional hypertension study of the elderly patients over 60 years old analyzed blood pressure in two opportunities separated by two days. Twenty-four patients had the blood pressure measured among 70 patients. Results: the systolic blood pressure were between 120-190mmHg, the diastolic blood pressure between 60-100mmHg. Eighteen (75%) were women, 17 (70.83%) does not have other chronic diseases, four (16.22%) had diabetes type II, three (12.50%) were dislipidemic. In ten (41.67%) patients the systolic blood pressure was over 140mmHg and four (16.67%) had the diastolic blood pressure over 90mmHg. The hypertension was uncontrolled in two fifty of elderly patients. Keywords: Hypertension. Elderly. Control.


2020 ◽  
Author(s):  
Clarissa Ern Hui Fang ◽  
Catherine Crowe ◽  
Annette Murphy ◽  
Martin O’Donnell ◽  
Francis Martin Finucane

Abstract Objective: We sought to determine whether the presence of cervical or axillary skin tags was associated with an adverse cardiovascular risk profile in Irish adults with severe obesity. Results: We conducted a cross-sectional study of patients attending our regional bariatric centre. Of 167 patients, 100 (31% male, 37% with type 2 diabetes, 36% on lipid lowering therapy, 41% on antihypertensive therapy) agreed to participate. 85 patients had cervical or axillary tags while 15 had none. Those with any skin tags had higher systolic blood pressure (138.0±16.0 versus 125.1±8.3 mmHg, p=0.003) and higher glycated haemoglobin (HbA1c) (46.5±13.2 versus 36.8±3.5 mmol/mol, p=0.017). 94.6% of patients with diabetes, compared to 79.4% of those without diabetes had skin tags (p=0.039). 45.8% of patients with skin tags compared to 13.3% with no tags were on antihypertensive therapy (p=0.018). Skin tags were not associated with any differences in lipid profiles. In Irish adults with severe obesity, skin tags are associated with higher systolic blood pressure and HbA1c and a higher prevalence of diabetes and hypertension, consistent with increased vascular risk, though differences in lipid profiles were not found.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Penson ◽  
S Javed ◽  
M Banach ◽  
G Y H Lip

Abstract Background Abdominal aortic calcification (AAC) has recently been recognised as a risk factor for cardiovascular disease, as it shares pathophysiological mechanisms with coronary artery disease. Purpose We investigated relationships between AAC and traditional cardiovascular risk factors in a cross-sectional epidemiological cohort from the USA Methods We used data from the National Health and Nutrition Evaluation Survey (NHANES) from the years 2103–2014. Dual-energy X-ray absorptiometry (DXA scans) were performed for a subset of 3140 NHANES participants over the age of 40. The images were scored according to ACC-24, a 24-point scale. We performed binary logistic regression to investigate relationships between demographic variables (age, sex, poverty income ratio, & educational status) CV risk factors (triglycerides (fasting, and non-fasting) LDL-C, HDL-C systolic blood pressure, body mass index, smoking status & diabetes) medicine use (statins, antihypertensives and antiplatelets) and AAC status (patients with a score ≥2 on the 24-point scale were considered AAC positive). Non normally-distributed variables were categorised for the purposes of analysis. Results Participants with AAC were older (mean 65.5 years ± SD 11.7) than unaffected individuals (56.1±11.1) AAC was also associated with higher BMI (28.7±5.8 v. 27.6±4.8 kg/m2), and higher systolic blood pressure (131.3±19.5 v 125.8±18.4 mmHg). We found a strong relationship between plasma triglyceride concentrations and AAC. In univariate analysis, fasting triglycerides above the first quartile were associated with approximately double the risk of AAC, compared to those in the first quartile (see table). This relationship persisted when the analysis was adjusted for demographics, risk factors and medicine use. A similar pattern was seen with non-fasting triglycerides (see table). Conclusions We found a strong relationship between triglycerides and AAC. Further work is required to determine whether this observation can be validated in other cohorts, and whether interventions to reduce triglyceides can alter the progression of AAC. FUNDunding Acknowledgement Type of funding sources: None. Odds ratios (95% CI) for AAC


2021 ◽  
Vol 9 (2) ◽  
pp. 123-127
Author(s):  
Etisa Adi Murbawani ◽  
Etika Ratna Noer ◽  
Enny Probosari

Background: Hypertension is a highly prevalent health problem which incidence is greatest among the elderly. Hypertension may increase creatinine level and leads to other health problems like diabetes mellitus, kidney damage, and cardiovascular disease. Wrist circumference is a simple anthropometric measurement that can be used to identify hypertension and increasing level of serum creatinine.Objectives: To analyze the correlation of wrist circumference with blood pressure and creatinine level among the elderly.Materials and Methods: This was a cross-sectional study with a purposive sampling method. Subjects of this study were 84 women aged 60 years old or above at Unit Rehabilitasi Sosial Pucang Gading Semarang. The independent variable of this study was wrist circumference, and the dependent variables were systolic blood pressure, diastolic blood pressure, and creatinine level. The result was analyzed using the Spearman-rho test.Results: The participants of this research were 49% women aged 60-65 years old, with an average age was 65.5 years old. The prevalence of hypertension was 61.9%. Most hypertension incidence in this research was caused by high systolic blood pressure (50%), and the rest was caused by high diastolic blood pressure (3.9%) and both (46.1%). The level of creatinine was normal with an average level was 0.75 mg/dL. There was no correlation of wrist circumference with systolic blood pressure systolic (r=0.15; p=0.19), diastolic blood pressure (r=0.1; p=0.38), and creatinine serum (r=0.18; p=0.09) among elderly.Conclusions: There was no correlation of wrist circumference with blood pressure and creatinine level among the elderly.


Heart ◽  
2019 ◽  
Vol 105 (14) ◽  
pp. 1070-1077 ◽  
Author(s):  
Mi-Hyang Jung ◽  
Sang-Wook Yi ◽  
Sang Joon An ◽  
Jee-Jeon Yi

ObjectiveWe aimed to identify the following in all age groups among individuals without known hypertension and CVD: (1) Whether a systolic blood pressure (SBP) of 130–139 mm Hg elevates cardiovascular disease (CVD) mortality. (2) Whether SBP shows a linear association with cause-specific CVD mortality.MethodsWe used the Korean National Health Insurance sample data (n=429 220). Participants were categorised into three groups by age (40–59 years, 60–69 years and 70–80 years).ResultsDuring 10.4 years of follow-up, 4319 cardiovascular deaths occurred. A positive and graded association was generally observed between SBP and overall and cause-specific CVD mortality regardless of age, except for ischaemic heart disease (IHD) mortality in those aged 70–80 years. Among those aged 70–80 years, the HRs (95% CIs) for overall CVD mortality were 1.08 (0.92–1.28), 1.14 (0.97–1.34) and 1.34 (1.14–1.58) for SBP values of 120–129 mm Hg, 130–139 mm Hg and 140–149 mm Hg, respectively, compared with SBP <120 mm Hg. For total stroke mortality, the corresponding HRs were 1.29 (1.02–1.64), 1.37 (1.09–1.72) and 1.52 (1.20–1.93), while for IHD mortality, the corresponding HRs were 0.90 (0.64–1.26), 0.86 (0.62–1.19) and 1.29 (0.93–1.78), respectively. Non-linear associations were significant for IHD.ConclusionsIn the elderly Korean population, SBPs of 130–139 mm Hg elevated total stroke mortality, but not IHD mortality, compared with normal blood pressure, and a linear association was not observed for IHD mortality in the range <140 mm Hg.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e035584
Author(s):  
Tom Wilsgaard ◽  
Anne Merete Vangen-Lønne ◽  
Ellisiv Mathiesen ◽  
Maja-Lisa Løchen ◽  
Inger Njølstad ◽  
...  

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.


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