Inter-Arm Blood Pressure Differences Are Associated With Cognitive Decline

Sounds like one of the testing protocols your doctor needs to do prior to leaving the hospital. So that if found your doctor's dementia prevention protocols can be initiated. Of course that assumes your doctor is competent in both testing and dementia prevention. Good luck with that.

Inter-Arm Blood Pressure Differences Are Associated With Cognitive Decline

By Erika Powers

VIRTUAL -- April 19, 2021 -- Systolic inter-arm blood pressure differences of ≥5 mm Hg and ≥10 mm Hg appear to be associated with onset of mild cognitive impairment (MCI), according to a study presented at the Virtual 2021 Joint Meeting of the European Society of Hypertension (ESH) and the International Society of Hypertension (ISH).

The findings come from the Inter-Arm Blood Pressure Difference - Individual Participant Data (INTERPRESS-IPD) Collaboration, where data from 57,434 participants across 24 studies from Europe, North America, East Asia, and Africa were merged.

“We present here the first time event analyses of inter-arm differences and cognitive decline,” said Christopher E. Clark, MD, University of Exeter Medical School, Exeter, Exeter, United Kingdom. “Systolic IADs of ≥5 mm Hg and ≥10 mm Hg were associated with development of mild cognitive impairment over 10 years in a pooled cohort of more than 4,000 participants.”

During the 10 years of follow-up, there were 273 (5.9%) new diagnoses of MCI among 4,635 participants from 3 cohorts. Mean age was 66.2 years, 55% were female, 84% white, and mean systolic inter-arm difference was 7.0 mm Hg.

In univariable analyses, MCI was associated with systolic inter-arm difference ≥5 mm Hg (hazard ratio [HR] = 1.34; 95% confidence interval [CI], 1.04-1.72; P = .022) and ≥10 mm Hg (HR = 1.33; 95% CI, 1.03-1.73; P = .032). After adjustment, associations with systolic inter-arm differences ≥5 mm Hg (HR = 1.31; 95% CI, 1.02-1.67; P = .036) and ≥10 mm Hg (HR = 1.29; 95% CI, 0.99-1.68; P = .056) remained.

There were 95 (2%) new diagnoses of dementia during follow-up, but there was no association between dementia diagnosis and inter-arm blood pressure difference.

Mini Mental State Examination (MMSE) scores were recorded for 2,709 participants from 3 cohorts. Of the participants, 419 (15.5%) showed significant decreases in scores -- defined as ≥5 points -- during follow-up. Decreases in MMSE scores were associated with inter-arm differences ≥5 mm Hg (P = .004) and ≥10 mm Hg (P = .006) on univariable analyses, and remained associated after adjusted with an inter-arm difference ≥5 mm Hg (P = .033).

“Hypertension and dementia are associated with older age and each other; however, no interventions halt established cognitive decline, therefore approaches focus on prevention,” noted Dr. Clark. “We are working to enlarge the dataset and develop these analyses further. If confirmed, these findings could inform individualised treatment decisions to minimise risk of future cognitive decline.”

[Presentation title: Cardiovascular Risk Factors Systolic Inter-Arm Blood Pressure Difference and Cognitive Decline: Findings From the INTERPRESS-IPD Collaboration. Abstract 15.14]