title: High daytime and nighttime ambulatory  pulse pressure predict poor cognitive  function and mild cognitive impairment  in hypertensive individuals.
abstract: High blood pressure accelerates normal aging stiffness process. Arterial stiffness (AS) has been previously associated with impaired cognitive function and dementia. Our aims are to study how cognitive function and status (mild cognitive impairment, MCI and normal cognitive aging, NCA) relate to AS in a community-based population of hypertensive participants assessed with office and 24-hour ambulatory blood pressure measurements. Six hundred ninety-nine participants were studied, 71 had MCI and the rest had NCA. Office pulse pressure (PP), carotid-femoral pulse wave velocity, and 24-hour ambulatory PP monitoring were collected. Also, participants underwent a brain magnetic resonance to study cerebral small-vessel disease (cSVD) lesions. Multivariate analysis-related cognitive function and cognitive status to AS measurements after adjusting for demographic, vascular risk factors, and cSVD. Carotid-femoral pulse wave velocity and PP at different periods were inversely correlated with several cognitive domains, but only awake PP measurements were associated with attention after correcting for confounders (beta = -0.22, 95% confidence interval (CI) -0.41, -0.03). All ambulatory PP measurements were related to MCI, which was independently associated with nocturnal PP (odds ratio (OR) = 2.552, 95% CI 1.137, 5.728) and also related to the presence of deep white matter hyperintensities (OR = 1.903, 1.096, 3.306). Therefore, higher day and night ambulatory PP measurements are associated with poor cognitive outcomes.
authors.forename: Iolanda
authors.initials: I
authors.lastname: Riba-Llena
authors.forename: Cristina
authors.initials: C
authors.lastname: Nafría
authors.forename: Josefina
authors.initials: J
authors.lastname: Filomena
authors.forename: José L
authors.initials: JL
authors.lastname: Tovar
authors.forename: Ernest
authors.initials: E
authors.lastname: Vinyoles
authors.forename: Xavier
authors.initials: X
authors.lastname: Mundet
authors.forename: Carmen I
authors.initials: CI
authors.lastname: Jarca
authors.forename: Andrea
authors.initials: A
authors.lastname: Vilar-Bergua
authors.forename: Joan
authors.initials: J
authors.lastname: Montaner
authors.forename: Pilar
authors.initials: P
authors.lastname: Delgado
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D001921:Brain / Q000098:blood supply / Q000473:pathology; D059345:Cerebral Small Vessel Diseases / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D003072:Cognition Disorders / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D059289:Vascular Stiffness / Q000502:physiology*