Blood Pressure Variability Linked to Cognitive Decline

What is it about?

Mild cognitive impairment (MCI) is the intermediate state between healthy ageing and dementia and is a stage at which intervention could be effective in reducing conversion to dementia. Neurocardiovascular instability is an age-related dysregulation of the blood pressure systems manifesting as exaggerated blood pressure variability and orthostatic hypotension (OH). Previous evidence has shown that autonomic dysfunction, blood pressure variation and hypotension are associated with mild cognitive impairment. Our study found that systolic blood pressure variation was associated with cognitive decline. Mild cognitive impairment participants were more likely to have had OH and more prolonged OH compared to cognitively normal controls. Mild cognitive impairment participants with impaired orthostatic blood pressure responses were twice more likely to convert to dementia than mild cognitive impairment participants without the impaired response over a three year follow-up period.

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Why is it important?

Our study provides longitudinal insights that may inform the development of clinical guidelines for the care of individuals with mild cognitive impairment. This abnormal blood pressure variability could be identified in primary care practice. Further research is necessary given these findings, as it is plausible that interventions to treat orthostatic hypotension may prevent or delay cognitive decline. Following confirmation of our findings with a bigger sample, development of an intervention trial to investigate if prevention of this slow recovery following active stand and prolonged orthostatic hypotension could prevent conversion to dementia in individuals with mild cognitive impairment should be carried out and implemented.