title: Relationship Between 24-Hour Ambulatory Blood Pressure and Cognitive Function in Community-Living Older Adults: The UCSD Ambulatory Blood Pressure Study.
abstract: BACKGROUND
  Twenty-four-hour ambulatory blood pressure (BP) patterns have been associated with diminished cognitive function in hypertensive and very elderly populations. The relationship between ambulatory BP patterns and cognitive function in community-living older adults is unknown.
  
  
  METHODS
  We conducted a cross-sectional study in which 24-hour ambulatory BP, in-clinic BP, and cognitive function measures were obtained from 319 community-living older adults.
  
  
  RESULTS
  The mean age was 72 years, 66% were female, and 13% were African-American. We performed linear regression with performance on the Montreal Cognitive Assessment (MoCA) as the primary outcome and 24-hour BP patterns as the independent variable, adjusting for age, sex, race/ethnicity, education, and comorbidities. Greater nighttime systolic dipping (P = 0.046) and higher 24-hour diastolic BP (DBP; P = 0.015) were both significantly associated with better cognitive function, whereas 24-hour systolic BP (SBP), average real variability, and ambulatory arterial stiffness were not.
  
  
  CONCLUSIONS
  Higher 24-hour DBP and greater nighttime systolic dipping were significantly associated with improved cognitive function. Future studies should examine whether low 24-hour DBP and lack of nighttime systolic dipping predict future cognitive impairment.
authors.affiliation: Divisions of Nephrology, University of California, San Diego School of Medicine, San Diego, California, USA;
authors.forename: Kyle S
authors.initials: KS
authors.lastname: Conway
authors.affiliation: Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, California, USA;
authors.forename: Nketi
authors.initials: N
authors.lastname: Forbang
authors.affiliation: Divisions of Nephrology, University of California, San Diego School of Medicine, San Diego, California, USA;
authors.forename: Tomasz
authors.initials: T
authors.lastname: Beben
authors.affiliation: Family Medicine and Public Health, University of California, San Diego School of Medicine, San Diego, California, USA;
authors.forename: Michael H
authors.initials: MH
authors.lastname: Criqui
authors.affiliation: Divisions of Nephrology, University of California, San Diego School of Medicine, San Diego, California, USA; Veterans' Affairs Healthcare System, San Diego, California, USA.
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.affiliation: Divisions of Nephrology, University of California, San Diego School of Medicine, San Diego, California, USA; Veterans' Affairs Healthcare System, San Diego, California, USA. drifkin@ucsd.edu.
authors.forename: Dena E
authors.initials: DE
authors.lastname: Rifkin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003071:Cognition; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: aging; ambulatory blood pressure; blood pressure; cognitive function; hypertension.