title: A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study.
abstract: OBJECTIVE
  To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS).
  
  
  METHODS
  Prospective analyses.
  
  
  METHODS
  Thirty-nine centers.
  
  
  METHODS
  Seven thousand one hundred forty-nine women aged 65 and older.
  
  
  METHODS
  The Modified Mini-Mental State Examination (3MS) was used to assess global cognitive functioning. Participants who scored below pre-established cutpoints were scheduled for more-extensive neurocognitive assessments. Results from these assessments were centrally adjudicated.
  
  
  RESULTS
  The mean age of this group of 7,149 participants at baseline was 71.0 +/- 3.8, and the mean 3MS score was 95.2 +/- 4.3. During a mean follow-up period of 4.5 years, women without hypertension tended to have slightly higher 3MS scores than women with hypertension (P=.001), but the difference was not seen after adjustment for covariates (P=.17). Women with hypertension also appeared to be at greater risk for probable dementia or mild cognitive impairment (MCI) (hazard ratio=1.35, 95% confidence interval=1.07-1.70, P=.01), although when potential cofounders were accounted for, this association was no longer significant (P=.06).
  
  
  CONCLUSIONS
  Hypertension and high blood pressure at baseline were not independently associated with MCI or probable dementia over time in older, cognitively intact, postmenopausal women enrolled in WHIMS after other potential confounders were taken into account. These analyses should not be viewed as discouraging appropriate medical treatment for hypertension.
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennesse 38163, USA. Kjohnson@utmem.edu
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Colenda
authors.forename: Howard
authors.initials: H
authors.lastname: Fillit
authors.forename: Joann E
authors.initials: JE
authors.lastname: Manson
authors.forename: Kamal H
authors.initials: KH
authors.lastname: Masaki
authors.forename: Charles P
authors.initials: CP
authors.lastname: Mouton
authors.forename: Ronald
authors.initials: R
authors.lastname: Prineas
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Robinson
authors.forename: Sylvia
authors.initials: S
authors.lastname: Wassertheil-Smoller
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology*; D001794:Blood Pressure; D002118:Calcium / Q000008:administration & dosage; D003072:Cognition Disorders / Q000453:epidemiology*; D003327:Coronary Disease / Q000517:prevention & control; D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP) / Q000008:administration & dosage / Q000009:adverse effects; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000009:adverse effects; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D017698:Postmenopause; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011594:Psychometrics; D018570:Risk Assessment; D012307:Risk Factors; D013223:Statistics as Topic; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D004966:Estrogens, Conjugated (USP); C466383:Prempro; D014807:Vitamin D; D017258:Medroxyprogesterone Acetate; D002118:Calcium