Systolic Blood Pressure and Cognitive Decline in Older Adults With Hypertension.

Streit, Sven; Poortvliet, Rosalinde K E; Elzen, Wendy P J den; Blom, Jeanet W; Gussekloo, Jacobijn (2019). Systolic Blood Pressure and Cognitive Decline in Older Adults With Hypertension. Annals of Family Medicine, 17(2), pp. 100-107. Annals of Family Medicine 10.1370/afm.2367

[img] Text
Streit AnnFamMed 2019.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (622kB) | Request a copy

PURPOSE Hypertension trials often exclude patients with complex health problems and lack generalizability. We aimed to determine if systolic blood pressure (SBP) in patients undergoing antihypertensive treatment is associated with 1-year changes in cognitive/daily functioning or quality of life (QoL) in persons aged ≥75 years with or without complex health problems. METHODS We analyzed data from a population-based prospective cohort study (Integrated Systematic Care for Older Persons [ISCOPE]) with a 1-year follow-up. Stratified by SBP level in the year before baseline, we used mixed-effects linear regression models to evaluate the change from baseline to 1-year follow-up in outcome measures (Mini-Mental State Examination [MMSE], Groningen Activity Restriction Scale [GARS], and EQ-5D-3L). We adjusted for age, sex, and baseline MMSE/GARS/EQ-5D-3L scores and stratified for complex health problems as a proxy for frailty. RESULTS Participant (n = 1,266) age averaged 82.4 (SD 5) years, and 874 (69%) were women. For participants undergoing antihypertensive therapy (1,057; 83.5%) and with SBP <130 mm Hg, crude cognitive decline was 0.90 points MMSE, whereas in those with SBP >150 mm Hg, it was 0.14 points MMSE (ie, 0.76-point less decline; for trend = .013). Complex health problems modified the association of SBP with cognition; the association was seen in those with antihypertensive treatment ( for trend <.001), not in those without ( for trend = .13). Daily functioning/QoL did not differ across the strata of SBP or antihypertensive treatment. CONCLUSIONS Participants aged ≥75 years undergoing antihypertensive treatment, with SBP ≥130 mm Hg compared to <130 mm Hg, showed less cognitive decline after 1 year, without loss of daily functioning or QoL. This effect was strongest in participants with complex health problems. More studies should be conducted to determine if there is a causal relation and to understand the mechanism of the association observed.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Streit, Sven


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




Annals of Family Medicine




Doris Kopp Heim

Date Deposited:

19 Mar 2019 15:56

Last Modified:

11 Nov 2019 20:12

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

cognitive function daily functioning hypertension old age quality of life




Actions (login required)

Edit item Edit item
Provide Feedback