Blood pressure, blood pressure variability and the risk of poststroke dementia
| Autor: | Edo Richard, Nina A Hilkens, Catharina J.M. Klijn |
|---|---|
| Přispěvatelé: | Neurology, Public and occupational health, 10 Public Health & Methodologie, APH - Mental Health, APH - Methodology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Physiology Blood Pressure 030204 cardiovascular system & hematology Logistic regression 03 medical and health sciences 0302 clinical medicine All institutes and research themes of the Radboud University Medical Center Risk Factors Internal medicine mental disorders Internal Medicine medicine Dementia Humans 030212 general & internal medicine business.industry Blood Pressure Determination Odds ratio medicine.disease Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] Confidence interval Stroke Regimen Blood pressure Cohort Hypertension Cardiology Observational study Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Hypertension, 39, 1859-1864 Journal of hypertension, 39(9), 1859-1864. Lippincott Williams and Wilkins Journal of Hypertension, 39, 9, pp. 1859-1864 |
| ISSN: | 0263-6352 |
| DOI: | 10.1097/hjh.0000000000002841 |
| Popis: | Objective High blood pressure and blood pressure variability are potential, modifiable risk factors of poststroke dementia. We aimed to investigate the association between achieved blood pressure, blood pressure variability and poststroke dementia. Methods We studied 17 064 patients with noncardioembolic ischemic stroke included in the Prevention Regimen for Effectively avoiding Second Strokes (PRoFESS) trial. We analysed the data as a single observational cohort. We studied mean achieved SBP and DBP and blood pressure variability defined as coefficient of variation (SD/mean*100). The association between blood pressure and dementia was investigated with logistic regression analysis, correcting for sociodemographic factors and cardiovascular risk factors. Results During 39 818 person-years of follow-up, 817 patients were diagnosed with dementia (2.1 per 100 person-years). We found a significant nonlinear association between mean SBP and the risk of dementia, implying a U-shaped association between mean SBP and dementia. Mean SBP of 120-129 mmHg was associated with a significantly higher risk of dementia than 130-139 mmHg [odds ratio (OR) 1.28; 95% confidence interval (95% CI) 1.03-1.58]. There was no indication of a U-shaped association between mean DBP and dementia, and no significant association between mean DBP categories and dementia. Higher blood pressure variability was associated with an increased risk of dementia (OR 1.06 per point increase, 95% CI 1.02-1.04), independent of mean SBP. Conclusion Among patients with a recent noncardioembolic ischemic stroke, there appears to be a U-shaped association between achieved SBP and dementia. High blood pressure variability is associated with an increased risk of poststroke dementia. |
| Databáze: | OpenAIRE |
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