Blood pressure and dementia.

Blood pressure and dementia.

The variability of postural changes in systolic blood pressure is associated with an increased risk of dementia according to a new study.

To determine whether orthostatic hypotension (OHYPO) and variability of postural changes in blood pressure (BP) at visits are associated with the incidence of dementia, researchers studied 2,131 older adults from the Health, Aging, and Body Composition cohort study. Orthostatic blood pressure was assessed repeatedly over a five-year reference period. Incident dementia was determined more than 12 years after the reference period.

Of 2,131 participants (mean age 73 years, 53% female, 39% black), 309 (14.5%) had OPHY, 192 (9.0%) had systolic OPHY, 132 (6.2%) had diastolic OPHY, and 462 (21.7%) developed dementia. After adjusting for demographics, sitting systolic blood pressure (SBP), antihypertensive drugs, cerebrovascular disease, diabetes mellitus, depressive symptoms, smoking, alcohol, body mass index, and the presence of 1 or 2 alleles of APOE ε4, systolic OPHY was associated with an increased risk of dementia (adjusted hazard ratio [HR] 1.37, 95% confidence interval [CI]: 1.01-1.88), unlike diastolic OPHYO and OPHYO. The variability of postural changes in SBP was also associated with an increased risk of dementia (higher tertile of variability [VC]: adjusted HR 1.35; 95% CI 1.06-1.71).

In conclusion, systolic OHYPO and variability of SBP postural changes at visits were associated with an increased risk of dementia.