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Senior Moment? Check Blood Pressure

Exaggerations in Blood Pressure Variability May Increase Risk of Cognitive Dysfunction
WebMD Health News
Reviewed by Louise Chang, MD

May 17, 2006 -- Those senior moments you experience from time to time may actually be a result of exaggerations in your blood pressure variability, according to new research presented Wednesday at the 21st Annual Scientific Meeting of the American Society of Hypertension (ASH 2006) in New York City.

In the new study of 101 Japanese people aged 80 or older, the greater the numeric differences in blood pressure readings during the day, the greater the risk of cognitive dysfunction.

Aging is known to increase the risk of blood pressure variability, but exactly how these variations affect cognitive function is not clear, researcher Kenichi Sakakura, MD, of the Public Kiwa Clinic in Kumano, Mie, Japan, tells WebMD.

Treating Variability Helps

"To prevent the progression of cognitive dysfunction, it may be important to treat large blood pressure variations in the elderly," says Sakakura. Admitting that treatment for such variation is "difficult," he suggests that long-acting blood pressure medication may play an important role. The effects of these medications tend to last longer, and thus may keep blood pressure under control throughout the day.

"Although clinicians may be reluctant to treat older patients aggressively, perhaps because of perceived lower benefits or possible increased risk of medication side effects, these findings show the potential value of interventions," he says.

In the study, blood pressure was measured via 24-hour ambulatory blood pressure monitoring. This allows for the measurement of blood pressure at different times throughout the 24-hour period and gives a more accurate idea of the variations that might occur in a typical day. The researchers assessed cognitive function with the Mini-Mental State Examination (MMSE), a standard measure that tests five areas of cognitive function: orientation, registration, attention and calculation, recall, and language. In the study, about 55% were classified as having cognitive dysfunction. The greater the blood pressure variability seen on the 24-hour monitoring, the greater the risk of cognitive dysfunction, the researchers report.

The link between untreated high blood pressure and cognitive decline is well known, says Frederic Vagnini, MD, the medical director of Heart, Diabetes & Weight Loss Centers of New York and author of several books including Overcoming Metabolic Syndrome. Vagnini did not attend the meeting.

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