Study: Midlife Orthostatic Hypotension Increases Cognitive Decline Later in Life
Adults with orthostatic hypotension (OH) in midlife have a higher risk of developing dementia or experiencing greater cognitive decline over a 20-year period, according to the results of a recent study.
To examine the associations between OH and incident dementia and cognitive decline, the researchers prospectively analyzed 11,503 participants involved in the Atherosclerosis Risk in Communities (ARIC) study who had attended the first visit (1987-1989) and had no history of coronary heart disease or stroke. The researchers defined OH as a drop in systolic blood pressure of 20 mmHg or more or a drop in diastolic blood pressure of 10 mmHg or more upon standing from a supine position.
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Participants completed 3 neuropsychological tests that measured cognition in 1990 to 1992, 1996 to 1998, and 2011 to 2012, and dementia diagnosis was collected via cohort surveillance, telephone contact with participants or their proxy, or a comprehensive cognitive and neurologic exam in 2011 to 2013.
At the first visit, 6% of participants had OH. This population was 40% more likely to develop dementia than their counterparts without OH. The researchers found that this association was significantly higher in participants with hypertension.
In addition, the researchers found that individuals with OH had significantly more cognitive decline over 20 years compared with individuals without OH.
“Although typically considered a transient mechanism, these data suggest that OH, or the underlying disease conditions manifesting as OH, persist over time. Whether OH is a marker of vulnerability beyond that of standard hypertension measures, or whether repeated transient exposure to hypotension reduces perfusion to the brain sufficiently to lead to long-term cerebral dysfunction is an important area for further research,” the researchers concluded.
—Melissa Weiss
Reference:
Rawlings A, Juraschek S, Heiss G, et al. Orthostatic hypotension is associated with 20-year cognitive decline and incident dementia: the Atherosclerosis Risk in Communities (ARIC) study. Presented at: the American Heart Association Epidemiology and Prevention Lifestyle and Cardiometabolic Health 2017 Scientific Sessions; March 7-10, 2017; Portland, OR. http://www.abstractsonline.com/pp8/#!/4299/presentation/2691.