title: Nocturnal Blood Pressure in Young Adults and Cognitive Function in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.
abstract: BACKGROUND
  Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear.
  
  
  METHODS
  We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study, including 224 participants (mean age 30 years, 45% men, 63% African Americans). At the 20-year follow-up, the Stroop test (executive function), Digit Symbol Substitution Test (psychomotor speed), and Rey Auditory Verbal Learning Test (verbal memory) were assessed.
  
  
  RESULTS
  Baseline mean office, daytime, and nocturnal BP were 109/73, 120/74, and 107/59 mm Hg, respectively. Nocturnal BP dipping, calculated as (nocturnal systolic BP [SBP]--daytime SBP) × 100/daytime SBP, was divided into quartiles (Q1: -39.3% to -16.9%; Q2: -16.8% to -13.2%, Q3 [reference]: -13.1% to -7.8%, and Q4: -7.7% to +56.4%). In multiple regression analyses, the least nocturnal SBP dipping (Q4 vs. reference) and higher nocturnal diastolic BP level were associated with worse Stroop scores, with adjustments for demographic and clinical characteristics, and cumulative exposure to office BP during follow-up (β [standard error]: 0.37 [0.18] and 0.19 [0.07], respectively; all P < 0.05). Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test were not significantly associated with nocturnal SBP dipping or nocturnal SBP/diastolic BP levels.
  
  
  CONCLUSIONS
  Among healthy young adults, less nocturnal SBP dipping and higher nocturnal diastolic BP levels were associated with lower executive function in midlife, independent of multiple measures of office BP during long-term follow-up.
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; yyano@jichi.jp yuichiro.yano@northwestern.edu.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;
authors.forename: Hongyan
authors.initials: H
authors.lastname: Ning
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alaska, USA;
authors.forename: Paul
authors.initials: P
authors.lastname: Muntner
authors.affiliation: Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland, USA;
authors.forename: Jared P
authors.initials: JP
authors.lastname: Reis
authors.affiliation: Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alaska, USA;
authors.forename: David A
authors.initials: DA
authors.lastname: Calhoun
authors.affiliation: Hypertension Research Program and Department of Family Medicine, University of North Carolina at Chapel Hill, North Carolina, USA;
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Viera
authors.affiliation: Departments of Internal Medicine and Neurology and Stroke Program, University of Michigan Health System, Veterans Affairs Health Services Research and Development Center of Excellence, Ann Arbor, Michigan, USA;
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Levine
authors.affiliation: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA;
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Department of Medicine, Center for Behavioral Cardiovascular Health, Columbia University, New York, USA.
authors.forename: Daichi
authors.initials: D
authors.lastname: Shimbo
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;
authors.forename: Kiang
authors.initials: K
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;
authors.forename: Philip
authors.initials: P
authors.lastname: Greenland
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;
authors.forename: Donald
authors.initials: D
authors.lastname: Lloyd-Jones
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003071:Cognition / Q000502:physiology*; D003324:Coronary Artery Disease / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: blood pressure; cognitive function; hypertension; midlife; nocturnal blood pressure; young adults.