title: Pulse pressure and mild cognitive impairment.
abstract: OBJECTIVE
  Patients with suboptimal blood pressure (BP) control may remain with an elevated cardiovascular risk and risk for cognitive impairment. Pulse pressure (PP) assessed with ambulatory BP monitoring (ABPM) or self-measurement so far has been an underestimated risk factor for target organ damage.
  
  
  METHODS
  One hundred and forty-eight patients were screened: 51 men (34.5%) and 97 women (65.5%), mean age 64.16 ± 11.18 years and a mean hypertension history of 13.1 ± 11.05 years. We gathered full medical and hypertension history, physical examination, laboratory screening and ambulatory blood pressure monitoring. Neuropsychological profile was assessed with tests (NPTs): Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).
  
  
  RESULTS
  Regression analysis found a correlation between day and night PP and NPT results. Mann-Whitney Test (α less than 0.05) was used to find a significant difference (P = 0.02 for MMSE) in the mean values of the NPT results between the groups with PP more than 50 and PP 50  mmHg or less. The result was not age dependent. There was also a significant difference between mean values of day-PP (P = 0.01) and night-PP (P = 0.02) between patients with cognitive impairment and those without (respectively more than 55  mmHg and less than 55  mmHg).
  
  
  CONCLUSIONS
  Elevated PP during the day, the night or with self-measurement is correlated with cognitive impairment. It is a marker of large artery stiffness and target organ damage not only in the very elderly, but also in younger individuals (mean age 64.16 years).
authors.affiliation: Cardiology Clinic, University Hospital 'Alexandrovska' Sofia, Bulgaria. teodora.yaneva@gmail.com
authors.forename: Teodora
authors.initials: T
authors.lastname: Yaneva-Sirakova
authors.forename: Rumiana
authors.initials: R
authors.lastname: Tarnovska-Kadreva
authors.forename: Latchezar
authors.initials: L
authors.lastname: Traykov
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D003071:Cognition; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D059289:Vascular Stiffness