Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiology of Vascular Aging

Neurology. 1999 Dec 10;53(9):1948-52. doi: 10.1212/wnl.53.9.1948.


Objective: To examine whether baseline high blood pressure and antihypertensive treatment predicts cognitive decline in elderly individuals.

Methods: A longitudinal population-based study of elderly individuals (n = 1,373) in Nantes (western France) was undertaken. Individuals 59 to 71 years of age were selected from electoral rolls. High blood pressure at baseline was defined as systolic blood pressure > or =160 mm Hg or diastolic blood pressure > or =95 mm Hg. Cognitive decline was defined as a drop of 4 points or more on the Mini-Mental State Examination between baseline and the 4-year assessment.

Results: There is an association between high blood pressure at baseline and cognitive decline at the 4-year assessment (odds ratio, 2.8; 95% CI, 1.6 to 5.0). In participants with high blood pressure, the risk of cognitive decline was 4.3 (95% CI, 2.1 to 8.8) in those without antihypertensive therapy and 1.9 (95% CI, 0.8 to 4.4) in those being treated. In participants with high blood pressure both at baseline and at the 2-year assessment, the risk for untreated participants was 6.0 (95% CI, 2.4 to 15.0) compared with 1.3 (95% CI, 0.3 to 4.9) in treated participants.

Conclusions: High blood pressure was associated with cognitive decline. In individuals with high blood pressure, cognitive decline occurred in a relatively short time period and the risk was highest in untreated hypertensive patients.

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / drug therapy
  • Alzheimer Disease / psychology
  • Antihypertensive Agents / administration & dosage
  • Blood Pressure / drug effects
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / drug therapy
  • Cognition Disorders / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertensive Encephalopathy / diagnosis*
  • Hypertensive Encephalopathy / drug therapy
  • Hypertensive Encephalopathy / psychology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Odds Ratio
  • Risk


  • Antihypertensive Agents