title: Day-to-day variability in home blood pressure is associated with cognitive decline: the Ohasama study.
abstract: Although an association between high blood pressure and cognitive decline has been reported, no studies have investigated the association between home blood pressure and cognitive decline. Home blood pressure measurements can also provide day-to-day blood pressure variability calculated as the within-participant SD. The objectives of this prospective study were to clarify whether home blood pressure has a stronger predictive power for cognitive decline than conventional blood pressure and to compare the predictive power of the averaged home blood pressure with day-to-day home blood pressure variability for cognitive decline. Of 485 participants (mean age, 63 years) who did not have cognitive decline (defined as Mini-Mental State Examination score, <24) initially, 46 developed cognitive decline after a median follow-up of 7.8 years. Each 1-SD increase in the home systolic blood pressure value showed a significant association with cognitive decline (odds ratio, 1.48; P=0.03). However, conventional systolic blood pressure was not significantly associated with cognitive decline (odds ratio, 1.24; P=0.2). The day-to-day variability in systolic blood pressure was significantly associated with cognitive decline after including home systolic blood pressure in the same model (odds ratio, 1.51; P=0.02), whereas the odds ratio of home systolic blood pressure remained positive, but it was not significant. Home blood pressure measurements can be useful for predicting future cognitive decline because they can provide information not only on blood pressure values but also on day-to-day blood pressure variability.
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. tohkubo@mail.tains.tohoku.ac.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsumoto
authors.forename: Michihiro
authors.initials: M
authors.lastname: Satoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Mikio
authors.initials: M
authors.lastname: Hirano
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Takanao
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Takuo
authors.initials: T
authors.lastname: Hirose
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Aya
authors.initials: A
authors.lastname: Hosokawa
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Toru
authors.initials: T
authors.lastname: Hosokawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D044466:Asian People; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000208:ethnology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology*; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; cohort studies; mild cognitive impairment