Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study.
Jin-Qiu Yuan, Yue-Bin Lv, Hua-Shuai Chen and 9 others
PMID 30017702WHAT IT FOUND
In 12,281 cognitively normal Chinese older adults, hypertension was linked to a higher risk of new cognitive impairment over about six years.
Low blood pressure findings were less clear.
Key findings
01During 66,619.9 person-years, 4,413 cases of mild/moderate/severe cognitive impairment occurred, and hypertension was associated with a higher adjusted risk (HR 1.17, 95% CI 1.10 to 1.24).
02Each 10 mmHg increase in systolic blood pressure was associated with a 5% increase in the risk of mild/moderate/severe cognitive impairment.
03Low systolic blood pressure under 110 mmHg tended to have higher adjusted risk of moderate/severe cognitive impairment (HR 1.32, 95% CI 1.06 to 1.64).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational, not a trial, so it reports association rather than a tested treatment effect. Residual confounding by other unmeasured or unknown factors was still possible. Many factors that may influence the relationship, such as duration of hypertension, treatment for hypertension, and plasma glucose, were not collected and could not be analyzed. Low blood pressure estimates were imprecise because the sample size was small. People who died or were lost to follow-up before the first follow-up survey were excluded and may have differed from those included. The moderate/severe cognitive impairment outcome had a low event rate (16.8%).
Declared interests
No author conflicts are stated in the supplied text. The supplied publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that treating blood pressure will prevent cognitive impairment. This cohort compared people who already had different blood pressures and did not test any blood pressure treatment.