PP.16.11] RELATIONSHIP BETWEEN BLOOD PRESSURE VARIABILITY AND COGNITIVE FUNCTION IN ELDERLY PATIENTS WITH STRICT BLOOD PRESSURE CONTROL

Abstract

Objective: Although higher blood pressure (BP) level and BP variability has been associated with decline cognitive function, data are sparse regarding to the relationship between BP variability and cognitive function in elderly patients with strict BP control. The aim of this study is to test the hypothesis whether BP variability using ABPM would be associated with cognitive function assessed by MoCA in the population who has already achieved strict home BP control from DCAP Netwrok. Design and method: We analyzed 232 patients from the Disaster CArdiovascular Prevention (DCAP) network, which developed a web-based home BP monitoring to achieve BP control for the support in disaster area after East Japan Earthquake. All patients were performed ambulatory BP monitoring and the Japanese version of Montreal Cognitive Assessment (MoCA-J). Results: The mean age was 77.7 years, 33.6% were male, and 85.3% were administrated anti-hypertensive drug. Average 24-hour BP level was 118.7 ± 10.0/68.3 ± 6.4 mmHg. When we divided weighted standard deviation of systolic BP (SBP) as measure of BP variability into quartiles, the top quartile group was significantly lower total MoCA-J score (15.4 [95% confidence interval 14.2–16.7] vs. 17.9 [17.2–18.6]) and its domains, visuoexecutive (2.2 [1.9–2.6] vs. 2.8 [2.6–2.9]), abstraction (1.0 [0.7–1.2] vs. 1.3 [1.1–1.4]), attention (2.8 [2.4–3.1] vs. 3.6 [3.4–3.8]), and naming (2.1 [1.9–2.3] vs. 2.5 [2.4–2.6]) than the group of other quartiles after adjusted by age and 24-hr SBP. These associations were not found in the quartiles of 24-hour SBP. Conclusions: In elderly patients with strict ambulatory BP control, higher BP variability, not average ambulatory BP level, was associated with cognitive decline.