Abstract 11658: Riser Pattern is Associated With Mild Cognitive Impairment in Heart Failure Patients

Abstract

Introduction: The riser pattern, an abnormal blood pressure (BP) pattern in which sleep BP exceeds awake BP, is a predictor of adverse cardiovascular outcomes. Although the riser pattern is associated with various factors, its significance in heart failure (HF) patients has not been established. HF patients often suffer from cognitive impairment (CI), but the relationship between the riser pattern and CI is not clearly understood. Hypothesis: We tested the hypothesis that the riser pattern is associated with mild CI, a form of brain damage that could develop to dementia. Methods: We performed the Mini-Mental State Examination (MMSE), ambulatory BP monitoring, echocardiography, and blood tests in 444 HF patients just before they left the hospital. Mild CI, a measure of cognitive function, was defined as a score <26. Results: The mean age of the patients was 68±13 years; 61.5% were male; and 22.5% exhibited a riser pattern. The MMSE score was significantly lower in the Riser group than in the Non-riser group (23±5 vs 25±5, p<0.01). In multivariable logistic regression analysis, a riser pattern was significantly associated with mild CI (odds ratio 2.07, 95% confidence intervals 1.19-3.61, p<0.01) after adjusting for significant covariates. Conclusions: A riser pattern was associated with mild CI in HF patients. An abnormal circadian BP rhythm in HF patients is clinically significant as a potential indicator of subclinical brain damage.