03609nas a2200625   4500000000100000008004100001653001100042653001100053653000900064653002200073653000900095653001600104653001700120653003000137653003000167653001400197653002200211653004200233653004200275653003100317653006100348653004400409653003500453653003000488653003800518653002700556653006200583653002600645653002900671653002600700100001100726700001300737700001800750700001500768700001400783700001700797700001200814700001300826700001400839700001300853700001700866700001900883700001400902700001300916700001300929700001300942700001600955700001300971245014100984250001501125300001101140490000701151520177401158020005102932       2015                            d10aFemale10aHumans10aAged10aFollow-Up Studies10aMale10aMiddle Aged10aRisk Factors10aPredictive Value of Tests10aDrug Therapy, Combination10aIncidence10aAged, 80 and over10aRandomized Controlled Trials as Topic10aCardiovascular Diseases/ epidemiology10aBlood Pressure/ physiology10aAngiotensin-Converting Enzyme Inhibitors/therapeutic use10aAntihypertensive Agents/therapeutic use10aBenzimidazoles/therapeutic use10aBenzoates/therapeutic use10aCognition Disorders/ epidemiology10aHeart Rate/ physiology10aHypertension/ complications/drug therapy/ physiopathology10aMultivariate Analysis10aRamipril/therapeutic use10aRetrospective Studies1 aTeo K.1 aUnger T.1 aSchumacher H.1 aSleight P.1 aDiener H.1 aO'Donnell M.1 aLonn E.1 aRedon J.1 aFagard R.1 aSliwa K.1 aSchmieder R.1 aAnderson Craig1 aMancia G.1 aBöhm M.1 aYusuf S.1 aLeong D.1 aCustodis F.1 aLaufs U.00aSystolic blood pressure variation and mean heart rate is associated with cognitive dysfunction in patients with high cardiovascular risk  a2015/01/15  a651-610 v653 a<p>
Elevated systolic blood pressure (SBP) correlates to cognitive decline and incident dementia. The effects of heart rate (HR), visit to visit HR variation, and visit to visit SBP variation are less well established. Patients without preexisting cognitive dysfunction (N=24 593) were evaluated according to mean SBP, SBP visit to visit variation (coefficient of variation [standard deviation/meanx100%], CV), mean HR, and visit to visit HR variation (HR-CV) in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial and the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease. Cognitive function was assessed with mini mental state examination. Cognitive dysfunction (fall in mini mental state examination <!--=24 points), important cognitive decline (drop of -->/=5 points), and cognitive deterioration (drop of &gt;1 point per year or decline to &lt;24 points) were assessed. SBP and HR were measured over 10.7+/-2.2 (mean+/-SD) visits. Mean SBP, mean HR, and SBP-CV were associated with cognitive decline, dysfunction, and deterioration (all P&lt;0.01, unadjusted). After adjustment, only SBP-CV (P=0.0030) and mean HR (P=0.0008) remained predictors for cognitive dysfunction (odds ratios [95% confidence intervals], 1.32 [1.10-1.58] for 5th versus 1st quintile of SBP-CV and 1.40 [1.18-1.66] for 5th versus 1st quintile of mean HR). Similar effects were observed for cognitive decline and deterioration. SBP-CV and mean HR showed additive effects. In conclusion, SBP-CV and mean HR are independent predictors of cognitive decline and cognitive dysfunction in patients at high CV risk. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101.
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