Journal of Hypertension

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Journal of Hypertension:
Original article

Is nondipping in 24 h ambulatory blood pressure related to cognitive dysfunction?

van Boxtel, Martin P.J.1,5; Gaillard, Carlo2; Houx, Peter J.1; Buntinx, F3; de Leeuw, Peter W.4; Jolles, Jellemer1

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Abstract

Objective: Associations between the outcome of 24 h ambulatory monitoring and cognitive performance were studied in order to evaluate the potential relevance of ambulant blood pressure status to brain function. It was hypothesized that a small daytime–night-time difference in mean blood pressure (nondipping) is associated with reduced cognitive performance, in line with studies in hypertensive subjects that have reported associations between nondipping and target-organ damage.

Methods: The study followed a cross-sectional design and was part of a larger research programme on determinants of cognitive aging (Maastricht Aging Study, MAAS). A group of 115 community residents aged 28–82 years was recruited from a general practice population and screened for cardiovascular events and medication use. All underwent 24 h blood pressure monitoring. Cognitive performance was measured with tests of verbal memory, attention, simple speed and information processing speed.

Results: Mean daytime or night-time levels of both systolic and diastolic blood pressure were unrelated to cognitive outcome, when age, sex and educational level were controlled for. Differences between mean daytime and night-time blood pressure (based on both narrow and wide measurement intervals for day and night-time periods) were positively associated with memory function (5–9% of additional variance explained) and one sporadic positive association was found on the sensorimotor speed score (4%). Nondippers (n = 15) showed lower levels of both memory and sensorimotor speed scores.

Conclusions: Ambulatory blood pressure status was not associated with cognitive performance. A reduced nocturnal blood pressure drop was associated with quite specific cognitive deficits, but the underlying mechanism remains to be determined.

© 1998 Lippincott Williams & Wilkins, Inc.

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