title: Blunted reduction in night-time blood pressure is associated with cognitive deterioration in subjects with long-standing hypertension.
abstract: OBJECTIVE
  Data about the relationship of blunted reduction of night-time blood pressure (BP) with cognitive deterioration (CD) are conflicting. This study aims to explore this possible association in elderly people with long-standing hypertension.
  
  
  METHODS
  Twenty-six hypertensive subjects consecutively admitted to a rehabilitation unit over a six-month period were recruited. Exclusion criteria concerned all clinical conditions potentially related to BP variability or leading to CD. All patients underwent a clinic and 24-h BP non-invasive monitoring assessment of BP, as well as a cognitive assessment with the Mini Mental State Examination (MMSE). The presence of cerebrovascular disease (CVD) was assessed on CT films, with a standardized visual rating scale.
  
  
  RESULTS
  Blunted reduction of both systolic and diastolic night-time BP were significantly associated with poorer cognitive performances (r=0.61, p=0.001 for systolic; and r=0.57, p=0.002 for diastolic, respectively). In a multiple regression model, blunted reduction of night-time BP (B=0.17, [95% confidence intervals: 1.1-1.3], p=0.008 for systolic; and B=0.15, [95% confidence intervals: 1.0-1.3], p=0.02 for diastolic) independently predicted poorer cognitive performances.
  
  
  CONCLUSIONS
  In subjects with long-standing hypertension the blunted reduction of night-time BP is independently associated with lower cognitive performances.
authors.affiliation: Rehabilitation Unit, Ancelle della Carità Hospital, Cremona, Italy. bellelli-giuseppe@poliambulanza.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bellelli
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Frisoni
authors.forename: Elena
authors.initials: E
authors.lastname: Lucchi
authors.forename: Fabio
authors.initials: F
authors.lastname: Guerini
authors.forename: Cristina
authors.initials: C
authors.lastname: Geroldi
authors.forename: Francesca
authors.initials: F
authors.lastname: Magnifico
authors.forename: Angelo
authors.initials: A
authors.lastname: Bianchetti
authors.forename: Marco
authors.initials: M
authors.lastname: Trabucchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002561:Cerebrovascular Disorders / Q000209:etiology; D002940:Circadian Rhythm; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D015999:Multivariate Analysis