Intensive blood pressure lowering may up cognitive decline in elderly
(HealthDay)—Older adults (aged ≥75 years) undergoing antihypertensive treatment with systolic blood pressure (SBP) >150 mm Hg have less cognitive decline than those with SBP <130 mm Hg, according to a study published in the March/April issue of the Annals of Family Medicine.
Sven Streit, M.D., Ph.D., from the University of Bern in Switzerland, and colleagues used data from the Integrated Systematic Care for Older Persons population-based prospective cohort study to assess whether SBP in older patients (average age, 82.4 years) undergoing antihypertensive treatment is associated with one-year changes in cognitive/daily functioning or quality of life (QoL).
The researchers found that among 1,057 participants undergoing antihypertensive therapy (83.5 percent of the study population), crude cognitive decline was less in those with SBP >150 mm Hg versus those with SBP <130 mm Hg (0.76-point less decline using the Mini-Mental State Examination; P for trend = 0.013). The relationship was modified by complex health problems. The association between SBP and cognition was seen in those with antihypertensive treatment (P for trend < 0.001) but not in those without (P for trend = 0.13). There were no significant differences in daily functioning/QoL across SBP measurements or antihypertensive treatment.
"Our results suggest that SBP thresholds for treatment should be redefined, especially for frail older persons," the authors write.
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