Predicting Risk of Cognitive Decline With Nocturnal Sleep Blood Pressure

Assessment of nocturnal sleep blood pressure (SBP) levels may help predict risk for cognitive deficits in middle-aged and older black adults, according to findings published in the Journal of the American Heart Association.

Investigators assessed nocturnal SBP among participants of the GENOA (Genetic Epidemiology Network of Arteriopathy) study (n=755). Participants underwent brain magnetic resonance imaging as well as various testing modalities to assess cognitive status.

The analysis found a race interaction between SBP and 2 cognitive function tests (both P <.15). An approximate 1-standard deviation increase in SBP correlated with lower scores for 2 tests that assessed for brain damage, dementia, and task switching (unstandardized regression coefficient -1.98; 95% CI, -3.28 to -0.69 and 0.06; 95% CI, 0.004-0.12; both P <.05) in black participants only. The researchers found no association between daytime SBP levels and cognitive decline/deficits.

This cross-sectional analysis failed to establish the direction of the observed correlations between race and the predictive value of SBP levels. Additionally, the study evaluated only a small number of patients from limited sites, reducing the likelihood that these findings can be applied to the entire US patient population.

Additional research may be essential to determine whether nocturnal SBP reductions “or restoration of normal circadian BP variation can help to limit declines in cognition in later life,” while considering things such as availability, cost effectiveness, and patient perspective.

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Yano Y, Butler KR, Hall ME, et al. Associations of nocturnal blood pressure with cognition by self-identified race in middle-aged and older adults: the GENOA (Genetic Epidemiology Network of Arteriopathy) study. J Am Heart Assoc. 2017;6(11).