Abstract
Objective: In the elderly, the effect of blood pressure on brain structure or cognitive function has not been clear. However, there are limitations in that most of studies was done using serial change in clinic blood pressure. We sought to determine the association of the ambulatory blood pressure over time with the brain structural alterations and cognitive function Design and method: In this study, we sought to examine the association between blood pressure and brain structure/cognitive function in the elderly over the age of 60 by using the 24-hour ambulatory blood pressure information at 2 different visits (mean time interval is 3.4 years). From October 2018, we included participants performed Korean Mini Mental State Exam; older than 60 years old among the participants in Cardiovascular and Metabolic Disease Etiology Research Center-High Risk Cohort. Results: When we divided the 170 participants into two groups according to the control of cumulative average daytime blood pressure, the cortical thickness of frontal lobe was thinner and the average hippocampal volume was smaller in the uncontrolled group (P = 0.002, P = 0.01 respectively). In multivariate linear analysis, the uncontrolled group for cumulative average daytime blood pressure was associated with thinner cortical thickness of frontal lobe and smaller average hippocampal volume (P = 0.007, P = 0.024 respectively). However, the baseline daytime blood pressure had no associations with brain structure or cognitive function. Conclusions: Our observations suggest that serial measurements of 24-hour ambulatory blood pressure may be important to assess the cumulative pressure load and the association with structural changes of the brain.
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