Blood Pressure-Related Cognitive Decline Does Age Make a Difference?

Abstract—Systolic and diastolic blood pressures have been inversely related to cognitive performance in prospective and cross-sectional studies. However, in large, community-based samples, these findings have been limited to older adults. In this 20-year longitudinal study, we examined the relationship between baseline blood pressure and cognitive decline for 529 participants using 2 age groups (18 to 46 years and 47 to 83 years). Cognitive performance was measured over multiple examinations with the Wechsler Adult Intelligence Scale from which 4 scores were derived by factor analysis. A 2-stage growth curve method of analysis was used to model cognitive change. Results indicated that higher levels of baseline systolic blood pressure, diastolic blood pressure, mean arterial pressure, and blood pressure categories as defined by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure were significantly associated with decline in Visualization/Fluid abilities in both younger and older age groups. Young adults are as susceptible to blood pressure-related longitudinal decline in cognitive performance as are older adults. (Hypertension. 2004;44:631-636.) Key Words: blood pressure age arterial hypertension cognition prospective studies risk factors Hypertension is related to poorer cognitive performancein adults,1,2 and hypertension-related changes in the brain are well-documented.3–9 Systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels have been inversel