Blunted reduction in night-time blood pressure is associated with cognitive deterioration in subjects with long-standing hypertension

Blood Press Monit. 2004 Apr;9(2):71-6. doi: 10.1097/00126097-200404000-00003.


Objective: Data about the relationship of blunted reduction of night-time blood pressure (BP) with cognitive deterioration (CD) are conflicting. This study aims to explore this possible association in elderly people with long-standing hypertension.

Methods: Twenty-six hypertensive subjects consecutively admitted to a rehabilitation unit over a six-month period were recruited. Exclusion criteria concerned all clinical conditions potentially related to BP variability or leading to CD. All patients underwent a clinic and 24-h BP non-invasive monitoring assessment of BP, as well as a cognitive assessment with the Mini Mental State Examination (MMSE). The presence of cerebrovascular disease (CVD) was assessed on CT films, with a standardized visual rating scale.

Results: Blunted reduction of both systolic and diastolic night-time BP were significantly associated with poorer cognitive performances (r=0.61, p=0.001 for systolic; and r=0.57, p=0.002 for diastolic, respectively). In a multiple regression model, blunted reduction of night-time BP (B=0.17, [95% confidence intervals: 1.1-1.3], p=0.008 for systolic; and B=0.15, [95% confidence intervals: 1.0-1.3], p=0.02 for diastolic) independently predicted poorer cognitive performances.

Conclusions: In subjects with long-standing hypertension the blunted reduction of night-time BP is independently associated with lower cognitive performances.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Pressure / physiology*
  • Blood Pressure Monitoring, Ambulatory
  • Cerebrovascular Disorders / etiology
  • Circadian Rhythm*
  • Cognition Disorders / etiology*
  • Female
  • Humans
  • Hypertension / complications*
  • Male
  • Multivariate Analysis