A U-shaped Association Between Blood Pressure and Cognitive Impairment in Chinese Elderly
Publication in refereed journal


Times Cited
Altmetrics Information
.

Other information
AbstractObjectives:
Higher or lower blood pressure may relate to cognitive impairment, whereas the relationship between blood pressure and cognitive impairment among the elderly is not well-studied. The study objective was to determine whether blood pressure is associated with cognitive impairment in the elderly, and, if so, to accurately describe the association.
Design:
Cross-sectional data from the sixth wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2011.
Setting:
Community-based setting in longevity areas in China.
Participants:
A total of 7144 Chinese elderly aged 65 years and older were included in the sample.
Measures:
Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured, pulse pressure (PP) was calculated as (SBP) − (DBP) and mean arterial pressures (MAP) was calculated as 1/3(SBP) + 2/3(DBP). Cognitive function was assessed via a validated Mini-Mental State Examination (MMSE).
Results:
Based on the results of generalized additive models (GAMs), U-shaped associations were identified between cognitive impairment and SBP, DBP, PP, and MAP. The cutpoints at which risk for cognitive impairment (MMSE <24) was minimized were determined by quadratic models as 141 mm Hg, 85 mm Hg, 62 mm Hg, and 103 mm Hg, respectively. In the logistic models, U-shaped associations remained for SBP, DBP, and MAP but not PP. Below the identified cutpoints, each 1-mm Hg decrease in blood pressure corresponded to 0.7%, 1.1%, and 1.1% greater risk in the risk of cognitive impairment, respectively. Above the cutpoints, each 1-mm Hg increase in blood pressure corresponded to 1.2%, 1.8%, and 2.1% greater risk of cognitive impairment for SBP, DBP, and MAP, respectively.
Conclusion:
A U-shaped association between blood pressure and cognitive function in an elderly Chinese population was found. Recognition of these instances is important in identifying the high-risk population for cognitive impairment and to individualize blood pressure management for cognitive impairment prevention.
All Author(s) ListYue-Bin Lv, Peng-Fei Zhu, Zhao-Xue Yin, Virginia Byers Kraus, DianeThreapleton, Choy-Lye Chei, Melanie Sereny Brasher, Juan Zhang, Han-Zhu Qian, Chen Mao, David Bruce Matchar, Jie-Si Luo, Yi Zeng, Xiao-Ming Shi
Journal nameJournal of the American Medical Directors Association
Year2017
Month2
Day1
Volume Number18
Issue Number2
Pages193.e7 - 193.e13
ISSN1525-8610
eISSN1538-9375
LanguagesEnglish-United Kingdom
KeywordsBlood pressure, hypertension, hypotension, cognitive impairment, curvilinear association, elderly

Last updated on 2020-20-10 at 03:20