title: Systolic blood pressure within an intermediate range may reduce memory loss in an elderly hypertensive cohort.
abstract: The objective of this study was to determine if maintenance of systolic blood pressure (BP) within a high range or low range among treated hypertensive patients increases the risk of memory decline. Biennial neuropsychological evaluations were performed on 158 hypertensive subjects. Decline/year was measured on the Cued Selective Reminding test (total free recall and delayed recall) in three systolic BP groups (low-i.e., mean systolic BP during the follow-up period < 135 mm Hg; intermediate-i.e., 135 mm Hg < or = mean systolic BP < or = 150 mm Hg; high-i.e., mean systolic BP > 150 mm Hg). In total free recall, the three systolic BP groups had significantly different declines per year (P = .02), with patients in the high subgroup showing the greatest decline. In delayed recall, the three systolic BP groups also showed significantly different declines per year (P = .04), with patients in the low subgroup having the greatest decline. Chronically elevated systolic BP > 150 mm Hg is associated with accelerated memory decline compared to older treated hypertensive patients with systolic BP in an intermediate range. Chronically maintained systolic BP within a low normal range < 135 mm Hg in older treated hypertensive subjects may be associated with accelerated memory decline, specifically in a test of delayed memory recall, compared to patients with systolic BP in an intermediate range. Optimal regulation of systolic BP may be a potential modifiable risk factor to prevent or minimize memory loss in older hypertensive patients.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: N
authors.initials: N
authors.lastname: Sacktor
authors.forename: S
authors.initials: S
authors.lastname: Gray
authors.forename: C
authors.initials: C
authors.lastname: Kawas
authors.forename: J
authors.initials: J
authors.lastname: Herbst
authors.forename: P
authors.initials: P
authors.lastname: Costa
authors.forename: J
authors.initials: J
authors.lastname: Fleg
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents