PP.29.27] EXAGGERATED BLOOD PRESSURE VARIABILITY IN BOTH OFFICE AND AMBULATORY BLOOD PRESSURE MONITORING ARE ASSOCIATED WITH COGNITIVE DYSFUNCTION IN EXTREMELY ELDERLY PATIENTS

Abstract

Objective: The objective of this study is to assess the association between cognitive dysfunction and blood pressure (BP) variability in extremely elderly patients, over 80 years. Design and method: This cross-sectional study were performed on 520 extremely very elderly outpatients (mean age: 83.2 ± 3.2 years, 44.0% male). These patients had normal activities of daily living. We evaluated cognitive function, office BP values during 1 year and BP values measured by 24-hour ambulatory BP monitoring. Cognitive function was evaluated by a visual working memory test consisted of three figures. The number of figures recalled was counted as the test score. We divided patients into two groups, 0 or 1 score as group 1, and 2 or 3 score as group 2. We used standard deviation (SD), coefficient of variation (CV), weighted SD, average real variability (ARV) and the maximum and minimum BP difference (MMD) to assess the BP variability. Results: A total of 70 patients (mean age: 84.0 ± 3.6 years, 35.7% male) constituted group 1, while the remaining 450 patients (mean age: 83.0 ± 3.1 years, 45.3% male) constituted group 2. There were no significant differences in office and 24-hour ambulatory systolic/diastolic BP levels between two groups. However, visit-to-visit systolic BP variability and all 24-hour ambulatory systolic/diastolic BP variability parameters in group 1 were significantly higher than those in group 2 even after adjusting for age (Table 1). Conclusions: Exaggerated visit-to-visit BP variability and 24-hour ambulatory BP variability were related to cognitive dysfunction in extremely elderly patients.