Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging.
OBJECTIVE
To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals.


METHODS
A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at baseline was defined as systolic blood pressure > or =160 mm Hg or diastolic blood pressure > or =95 mm Hg. Cognitive decline was defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment.


RESULTS
There is an association between high blood pressure at baseline and cognitive decline at the 4-year assessment (odds ratio, 2.8; 95% CI, 1.6 to 5.0). In participants with high blood pressure, the risk of cognitive decline was 4.3 (95% CI, 2.1 to 8.8) in those without antihypertensive therapy and 1.9 (95% CI, 0.8 to 4.4) in those being treated. In participants with high blood pressure both at baseline and at the 2-year assessment, the risk for untreated participants was 6.0 (95% CI, 2.4 to 15.0) compared with 1.3 (95% CI, 0.3 to 4.9) in treated participants.


CONCLUSIONS
High blood pressure was associated with cognitive decline. In individuals with high blood pressure, cognitive decline occurred in a relatively short time period and the risk was highest in untreated hypertensive patients.
Tzourio
C
C
INSERM U 360, Hôpital de la Salpêtrière, Paris, France.
Dufouil
C
C
Ducimetière
P
P
Alpérovitch
A
A
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D012306:Risk
D000959:Antihypertensive Agents