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From the Department of Geriatrics (L.K., M.B., L.H., H.L.), Uppsala, and
the Department of Clinical Neurosciences (H.N.), Karolinska Hospital,
Stockholm, Sweden.
Correspondence to Dr Lena Kilander, Department of Geriatrics, Kålsängsgränd 10 D, PO Box 609, S-751 25 Uppsala, Sweden.
Abstract—Recent findings of a
linkage between high blood pressure (BP) and later development of
dementia have given new prospects on cerebral target-organ damage in
hypertension and have added substance to the concept of "preventable
senility." The aim of this study was to analyze the impact of
hypertension, circadian BP profile, and disturbed glucose
metabolism on cognitive function. The study population
consisted of 999 seventy-year-old men from a population-based cohort
study in Uppsala, Sweden, followed with respect to
cardiovascular risk factors since the age of 50 years.
At the age of 70, 24-hour ambulatory BP was monitored together with
measurements of insulin sensitivity, glucose tolerance, serum lipids,
and lipoproteins. Cognitive function was assessed by the Mini-Mental
State Examination and the Trail-Making Test. High diastolic
BP at baseline predicted later impaired cognitive performance,
even after excluding men with a previous stroke (n=70). Cross-sectional
measurements at age 70 showed that high 24-hour BP, nondipping, insulin
resistance, and diabetes all were related to low cognitive function.
The relationships between hypertension and cognitive impairment were
strongest in untreated men. These data from a general population of
healthy elderly men indicate that hypertension and associated
metabolic disturbances might be susceptibility
factors for cognitive disorders. The findings add support to
possibilities of intervention in early stages in cognitive decline, ie,
before manifest dementia.
© 1998 American Heart Association, Inc.
Scientific Contributions
Hypertension Is Related to Cognitive Impairment
A 20-Year Follow-up of 999 Men
Key Words: cognition • blood pressure monitoring, ambulatory • diabetes • insulin resistance
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