The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study.

TitleThe association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study.
Publication TypeJournal Article
Year of Publication1995
AuthorsLauner LJ, Masaki K, Petrovitch H, Foley D, Havlik RJ
JournalJAMA : the journal of the American Medical Association
Volume274
Issue23
Pagination1846-51
Date Published1995 Dec 20
ISSN0098-7484
KeywordsAged, Blood Pressure, Cognition, Cognition Disorders, Cohort Studies, Humans, Hypertension, Intelligence Tests, Male, Middle Aged, Risk Factors, Systole
Abstract

OBJECTIVE: To assess the long-term relationship of midlife blood pressure levels to late-life cognitive function.

DESIGN: The 4678 surviving cohort members of the prospective Honolulu Heart Program (baseline, 1965-1968) were examined a fourth time in 1991 through 1993 and given a cognitive test.

PARTICIPANTS: The subjects were 3735 Japanese-American men living in Hawaii in the community or in institutions, with an average age of 78 years at the fourth examination.

MAIN OUTCOME MEASURES: Cognitive function, measured by the 100-point Cognitive Abilities Screening Instrument (CASI), was categorized into good (reference: a CASI score of 92 to 100), intermediate (< 92 to 82), and poor (< 82). Midlife systolic blood pressure (SBP) and diastolic blood pressure (DBP) values were measured in 1965, 1968, and 1971. A respondent was classified into the following categories if two of three measurements fell into the following groups: for SBP, < 110, 110 to 139, 140 to 159, and > or = 160 mm Hg; and for DBP, < 80, 80 to 89, 90 to 94, and > or = 95 mm Hg.

RESULTS: When we controlled for age and education, the risk for intermediate and poor cognitive function increased progressively with increasing level of midlife SBP category (P for trend < .03 and < .001, respectively). For every 10-mm Hg increase in SBP there was an increase in risk for intermediate cognitive function of 7% (95% confidence interval [CI], 3% to 11%) and for poor cognitive function of 9% (95% CI, 3% to 16%). Adjustment for prevalent stroke, coronary heart disease, and subclinical atherosclerosis reduced the strength of the relationship between midlife SBP and poor cognitive function to 5% (95% CI, 0% to 12%). The level of cognitive function was not associated with midlife DBP.

CONCLUSIONS: Midlife SBP is a significant predictor of reduced cognitive function in later life. Early control of SBP levels may reduce the risk for cognitive impairment in old age.

Alternate JournalJAMA
PubMed ID7500533
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