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Association Between ABPM Phenotypes and Cognitive Impairment in a Community-Dwelling, Older Adult Population Taking Antihypertensive Medication: A Pilot Study

Year: 2025

Type: article

Abstract: BACKGROUND: Hypertension (HTN) is associated with an increased risk of cognitive impairment (CI). This study aimed to explore the relationship between Ambulatory BP Monitoring (ABPM) phenotypes and CI in a predominantly Black, older adult population. METHODS: This cross-sectional study enrolled adults ≥60 years of age with HTN and taking ≥1 antihypertensive. Participants had 3 seated BP readings taken 1 minute apart, followed by 24-hour ABPM. Cognitive impairment was determined using the Mini-Mental State Examination (MMSE-2) with a cutoff score of ≤25. 24-hour ABPM control was defined as <125/75, and seated BP control was defined as <130/80 mm Hg. A sleep BP decline of <10% was used to identify non-dippers. ABPM phenotypes were compared to categorical data measured by the MMSE-2 and analyzed using the Chi-square test. Unadjusted and adjusted (age and gender) prevalence ratios were also calculated. RESULTS: The 69 participants included in the analysis had a mean age of 69 years, 56.5% were female, and 73.9% identified as Black/African American. Cognitive impairment was identified in 29% (n = 20) of the participants according to their MMSE-2 score. Cognitive impairment prevalence was significantly higher among participants exhibiting a non-dipping BP pattern (75% vs 40.8%; P = .01), elevated sleep diastolic BP (P = .02), and 24-hour, awake, sleep, and seated heart rate (P < .05 for all). CONCLUSIONS: Sleep BP and heart rate were associated with a higher prevalence of CI and may offer clues as to the underlying pathophysiology of BP-associated CI. These findings warrant further study in a larger population followed longitudinally.

Source: American Journal of Hypertension

DOI: 10.1093/ajh/hpaf188

Authors: Trevor Sproule, Lana Sargent, Elvin Price, Marissa Mackiewicz, Leroy Thacker, Dave Dixon

Institutions: Virginia Commonwealth University, University of Central Florida

Language: English

Topic: Blood Pressure and Hypertension Studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: Boehringer Ingelheim, Georgia Clinical and Translational Science Alliance, National Institutes of Health, National Center for Advancing Translational Sciences