Senior Moment? Check Blood Pressure
Exaggerations in Blood Pressure Variability May Increase Risk of Cognitive Dysfunction
WebMD News Archive
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
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.
"Intensive management with lifestyle changes and medication can make a
difference in both blood pressure and cognitive function," he says. "I
do not accept senior moments," he tells WebMD, referring to the informal
term given to the momentary lapse in memory sometimes experienced by a senior
"If an older person starts having memory problems, it's a good idea to
rule out high blood pressure as a possible cause," he says.
Calling the findings "incredibly important," Thomas D. Giles, MD,
ASH president and a professor of medicine at Tulane University School of
Medicine in New Orleans, tells WebMD that the brain has one of the most
sensitive vascular systems (or system of blood vessels) in the body.
"The fact that certain surges in blood pressure affect these blood
vessels is exactly in keeping with the hypothesis that we want the brain to
receive the proper amount of blood flow at pressures that are not
excessive," he tells WebMD.