Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function
Background: Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function amon...
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my.sunway.eprints.30522024-08-10T07:53:16Z http://eprints.sunway.edu.my/3052/ Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function Nur Fazidah, Asmuje Sumaiyah, Mat Choon, Hian Goh Myint, Phyo Kyaw Tan, Maw Pin * RC Internal medicine Background: Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over. Methods: Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment. Results: Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments. Conclusion: Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline. Oxford University Press 2022 Article PeerReviewed Nur Fazidah, Asmuje and Sumaiyah, Mat and Choon, Hian Goh and Myint, Phyo Kyaw and Tan, Maw Pin * (2022) Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function. American Journal of Hypertension, 35 (12). pp. 998-1005. ISSN 1941-7225 https://doi.org/10.1093/ajh/hpac107 10.1093/ajh/hpac107 |
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RC Internal medicine Nur Fazidah, Asmuje Sumaiyah, Mat Choon, Hian Goh Myint, Phyo Kyaw Tan, Maw Pin * Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
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Background: Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over.
Methods: Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment.
Results: Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments.
Conclusion: Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline. |
format |
Article |
author |
Nur Fazidah, Asmuje Sumaiyah, Mat Choon, Hian Goh Myint, Phyo Kyaw Tan, Maw Pin * |
author_facet |
Nur Fazidah, Asmuje Sumaiyah, Mat Choon, Hian Goh Myint, Phyo Kyaw Tan, Maw Pin * |
author_sort |
Nur Fazidah, Asmuje |
title |
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
title_short |
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
title_full |
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
title_fullStr |
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
title_full_unstemmed |
Increased Beat-to-Beat Blood Pressure Variability Is Associated With Impaired Cognitive Function |
title_sort |
increased beat-to-beat blood pressure variability is associated with impaired cognitive function |
publisher |
Oxford University Press |
publishDate |
2022 |
url |
http://eprints.sunway.edu.my/3052/ https://doi.org/10.1093/ajh/hpac107 |
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1807053660573663232 |
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13.19449 |