Early Cognitive Screening is recommended for the Population with Higher Blood Pressure Variation: A Cross‐sectional Study from a Blood Pressure Management Cohort in Hong Kong

Abstract

AbstractBackgroundCognitive impairment was shown to be associated with blood pressure (BP) and blood pressure variability (BPV), but the association with BPV is still uncertain in Chinese. This study explored whether BPV is associated with cognitive impairment among the elderly in Hong Kong.MethodParticipants in a community‐based cohort for regular BP measurements with health surveys were randomly invited to have a cognitive assessment with a shortened validated version of MoCA. Different thresholds of mild cognitive impairment (MCI) were used with reference to the age group and educational background. BPV was defined as standard deviation. K‐means clustering methods were applied to group the standard deviation of BPV into high, medium, and low variations. Logistic and quantile regression models were conducted to explore the association of MCI with systolic or diastolic BPV and a combined BPV classification. Odds ratios (OR) were adjusted for age, gender, educational background social economic status, and other medical histories, including hypertension, hyperlipidemia, diabetes, and stroke.ResultA total of 573 participants with a mean age of 72 years were included. Most participants were females (86%). The median follow‐up times were eight months with a median number of nineteen BP records. Systolic BPV was shown to be associated with a higher risk of MCI (adjusted OR: 1.16; 95% CI: 1.03 to 1.31); whereas diastolic BPV was not significantly associated with MCI (adjusted OR: 1.05; 95% CI: 0.85 to 1.24) (Table 1). In the combined groupings for BPV classifications, participants with high BPV were shown to have around 5 times higher risk of MCI than those with low BPV.ConclusionEarly stage of cognitive impairment was shown to be associated with systolic blood pressure variability in the Hong Kong population. Early cognitive screening for those with high blood pressure variability levels is recommended.