Higher nocturnal blood pressures are associated with lower scores on tests of cognitive function

Higher levels of blood pressure at night?especially loss of the normal nocturnal dip in blood pressure?are linked to lower scores on tests of cognitive function, according to a presentation at the annual meeting of the American Society of Nephrology.

The results add to previous studies suggesting that information from 24-hour blood pressure monitoring is a better indicator of the risks of organ damage caused by hypertension than blood pressure readings performed in the doctor’s office.

Led by Gary L. Schwartz, MD, of the Mayo Clinic College of Medicine in Rochester, Minnesota, the researchers compared 24-hour blood pressure recordings with the results of standard cognitive tests in 389 patients, most of whom had hypertension.
The patients wore an ambulatory blood pressure monitor, which measures and records blood pressure over a 24-hour period while patients carry out their usual daily activities, including sleep. Past research has shown that one-time measurements of blood pressure in the doctor's office don't fully capture the health risks associated with disturbances of blood pressure.

Scores on the cognitive tests were significantly lower for patients with higher nocturnal blood pressure levels. This included tests of specific cognitive functions such as attention, processing speed, and others.

Normally, blood pressure drops by about 10 to 20 percent when a person lies down at night, compared with daytime levels. In the new study, patients who didn't have this normal night-time dip in blood pressure also scored lower on the cognitive tests. Cognitive scores were unrelated to the patient's daytime blood pressure levels on 24-hour monitoring, or to their blood pressure levels measured in the doctor's office.

Through the sustained effects of high blood pressure over time, hypertension can damage virtually every organ in the body?including the brain. High blood pressure has been linked to reduced cognitive functioning, even in young adults. The average age of the patients in the new study was 63 years.

The new results show that higher nocturnal blood pressure is also related to reductions in specific areas of cognitive functioning.

Dr. Schwartz said: "These studies suggest that we may have to pay more attention to blood pressure levels and patterns throughout the day and night in order to protect our patients from the harmful effects of high blood pressure."



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