title: Association between pulsatile blood pressure and cognitive performance among older adults: Insight from the National Health and Nutrition Examination Survey 1999-2002.
abstract: BACKGROUND
  High blood pressure (BP) may be associated with impaired cognitive function. BP is comprised of a steady (mean arterial pressure; MAP) and pulsatile (pulse pressure; PP) component. The purpose of this study was to examine the relationship between steady and pulsatile BP and cognition among adults ≥60years old.
  
  
  METHODS
  2058 adults age 60-85years from the 1999-2002 NHANES were used in this analysis. MAP and PP were calculated from brachial BP as 1/3 systolic +2/3 diastolic BP, and systolic - diastolic BP, respectively. Cognition was assessed using the digit-symbol substitution test (DSST).
  
  
  RESULTS
  Unadjusted multiple regression revealed although PP independently predicted DSST score (β=-0.21, p<0.05), MAP was only predictive when entered simultaneously with PP (β=0.06, p<0.05). Further adjustments for sociodemographics and medical history significantly improved prediction of DSST score (∆R2=0.37, p<0.05), and removed the association between MAP and DSST score, although PP remained a significant predictor (β=-0.07, p<0.05).
  
  
  CONCLUSIONS
  PP, but not MAP, was significantly and inversely related to cognitive function among a representative sample of adults aged ≥60years after controlling for sociodemographic information and medical history.
authors: Department of Exercise Science, Syracuse University, USA. Electronic address: wleffert@syr.edu.
authors: Wesley K
authors: WK
authors: Lefferts
authors: Department of Exercise Science, Syracuse University, USA.
authors: Kevin S
authors: KS
authors: Heffernan
authors: Department of Exercise Science, Syracuse University, USA.
authors: Tiago V
authors: TV
authors: Barreira
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D003071:Cognition / Q000502:physiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors; D013223:Statistics as Topic; D013647:Task Performance and Analysis; D014481:United States / Q000453:epidemiology
keywords: Cognition; NHANES; Pulsatile blood pressure