Systolic orthostatic hypotension (OHYPO) and variability in visit-to-visit seated systolic blood pressure (BP) postural change are associated with greater dementia risk, according to a study published online July 20 in Neurology.
Laure Rouch, PharmD, PhD, from University of California in San Francisco, and colleagues used data from 2,131 older adults (mean age, 73 years) participating in the Health, Aging, Body Composition study to evaluate whether OHYPO and visit-to-visit BP postural changes variability are associated with incident dementia. OHYPO was measured repeatedly during a five-year baseline period and was defined as a fall of ≥15 mm Hg in systolic BP or ≥7 mm Hg in diastolic BP after standing from a sitting position for at least one-third of visits.
The researchers found that overall, 9 percent of participants had systolic OHYPO, 6.2 percent had diastolic OHYPO, and 21.7 percent developed dementia. Systolic OHYPO was associated with greater dementia risk (adjusted hazard ratio [HR], 1.37) when adjusting for demographics, seated systolic BP, antihypertensive drugs, cerebrovascular disease, diabetes, depressive symptoms, smoking, alcohol, body mass index, and the presence of APOE ε4 alleles. However, there was no association seen for diastolic OHYPO. Variability in seated systolic BP postural changes was also associated with higher dementia risk (highest tertile of variability: adjusted HR, 1.35).
“Our findings raise the question of potential preventive interventions to control orthostatic systolic BP and its fluctuations,” the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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