Would this have the same effect on stroke survivors? We'll never know because we have no strategy to update or a leader to go to. You're on your own.
Higher systolic interarm difference (IAD) measurements in blood
pressure are associated with an increased risk of cognitive decline and
may alert health care practitioners of the need for preventive and
therapeutic intervention in the elderly, according to a study presented
here at the 26th Scientific Meeting of the European Society of
Hypertension (ESH).
Patients with elevated IAD in blood pressure also demonstrated higher mortality rates over a 9-year follow-up.
“Systolic IADs in blood pressure of 10 mm Hg are associated with increased cardiovascular disease and mortality. Both Alzheimer’s disease and vascular dementia include vascular disease in their aetiology,” explained John Campbell, MD, MBChB, University of Exeter Medical School, Exeter, United Kingdom, on June 12. “We hypothesised that an IAD may be prospectively associated with an increased risk of cognitive decline.”
Dr. Campbell and colleagues evaluated whether systolic IADs in blood pressure could identify people at risk for cognitive decline by use of the large database of the inChianti study. InChianti is a prospective study of ageing comprising detailed assessments of a random sample of older individuals with baseline assessments of sequential blood pressure measurements and cognitive assessment by the mini-mental state examination (MMSE).
The study enrolled >1,000 participants who were evaluated every 3 years during a 9-year follow-up. Associations between IAD and mortality, cognitive decline, and rate of change in MMSE over time were assessed by univariate cross-sectional and regression analyses adjusted for known cardiovascular and dementia risk factors.
A decline in MMSE score of ≥5 points was considered to be a clinically important substantial cognitive decline.
“The rate of change in cognitive scores may also be important in predicting risk of cognitive impairment,” noted Dr. Campbell.
Participants with IADs of ≥10 mm Hg showed a rate of decline in MMSE scores over time that was significantly greater than the rate in participants with no IAD in systolic blood pressure measurements. Participants with IAD demonstrated a decline at a rate of 0.51 MMSE points yearly, whereas participants without significant IAD showed a decline of 0.33 MMSE points per year (P = .024).
Individuals with IAD ≥10 mm Hg also demonstrated higher all-cause mortality rates at the 6- and 9-year follow-ups. The difference between participants with elevated IAD compared with those without IAD at 6 years (hazard ratio, 1.36; P = .04) was continued as a nonsignificant trend at 9 years.
“These results suggest a potential association of IAD with higher rates of cognitive decline that warrants further study using robust methods of measuring interarm blood pressure to clarify where detection of IAD can predict future cognitive decline,” concluded Dr. Campbell.
[Presentation title: Inter-Arm Blood Pressure Difference and Risk of Cognitive Decline: A 9-Year Prospective Cohort Study]
“Systolic IADs in blood pressure of 10 mm Hg are associated with increased cardiovascular disease and mortality. Both Alzheimer’s disease and vascular dementia include vascular disease in their aetiology,” explained John Campbell, MD, MBChB, University of Exeter Medical School, Exeter, United Kingdom, on June 12. “We hypothesised that an IAD may be prospectively associated with an increased risk of cognitive decline.”
Dr. Campbell and colleagues evaluated whether systolic IADs in blood pressure could identify people at risk for cognitive decline by use of the large database of the inChianti study. InChianti is a prospective study of ageing comprising detailed assessments of a random sample of older individuals with baseline assessments of sequential blood pressure measurements and cognitive assessment by the mini-mental state examination (MMSE).
The study enrolled >1,000 participants who were evaluated every 3 years during a 9-year follow-up. Associations between IAD and mortality, cognitive decline, and rate of change in MMSE over time were assessed by univariate cross-sectional and regression analyses adjusted for known cardiovascular and dementia risk factors.
A decline in MMSE score of ≥5 points was considered to be a clinically important substantial cognitive decline.
“The rate of change in cognitive scores may also be important in predicting risk of cognitive impairment,” noted Dr. Campbell.
Participants with IADs of ≥10 mm Hg showed a rate of decline in MMSE scores over time that was significantly greater than the rate in participants with no IAD in systolic blood pressure measurements. Participants with IAD demonstrated a decline at a rate of 0.51 MMSE points yearly, whereas participants without significant IAD showed a decline of 0.33 MMSE points per year (P = .024).
Individuals with IAD ≥10 mm Hg also demonstrated higher all-cause mortality rates at the 6- and 9-year follow-ups. The difference between participants with elevated IAD compared with those without IAD at 6 years (hazard ratio, 1.36; P = .04) was continued as a nonsignificant trend at 9 years.
“These results suggest a potential association of IAD with higher rates of cognitive decline that warrants further study using robust methods of measuring interarm blood pressure to clarify where detection of IAD can predict future cognitive decline,” concluded Dr. Campbell.
[Presentation title: Inter-Arm Blood Pressure Difference and Risk of Cognitive Decline: A 9-Year Prospective Cohort Study]
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