Greater Blood Pressure Variability Is Associated With Lower Cognitive Performance

Hypertension. 2019 Apr;73(4):803-811. doi: 10.1161/HYPERTENSIONAHA.118.12305.


An increasing number of individuals will face age-related cognitive difficulties because life expectancy has increased. It is, therefore, important to identify modifiable risk factors for cognitive impairment. Very short-term to mid-term blood pressure variability (BPV) may be such a factor because it may cause cerebral ischemia. To this end, we investigated whether greater systolic and diastolic BPV are cross-sectionally associated with memory function (n=1804), information processing speed (n=1793), and executive function (n=1780) in 40- to 75-year-old individuals from The Maastricht Study. A composite BPV-index was derived by standardizing within-visit, 24-hour, and 7-day BPV. We performed linear regression with adjustments for age, sex, educational level, 24-hour systolic or diastolic pressure, and cardiovascular risk factors. We found that a 1-SD greater systolic BPV was not associated with information processing speed (β [SD difference], -0.10; 95% CI, -0.14 to 0.06), or executive function (-0.09; 95% CI, -0.20 to 0.02) but was marginally associated with lower memory function (-0.11; 95% CI, -0.21 to 0.00). A 1-SD greater diastolic BPV was associated with lower information processing speed (-0.10; 95% CI, -0.20 to -0.00) and executive function (-0.12; 95% CI, -0.22 to -0.01) and marginally associated with lower memory function (-0.09; 95% CI, -0.20 to 0.01). These effects on cognitive performance are equivalent to ≈3 additional years of aging. In conclusion, greater very short-term to mid-term diastolic and, to a lesser extent, systolic BPV may be a modifiable risk factor for cognitive deterioration in 40- to 75-year-old, community-dwelling individuals.

Keywords: aging; blood pressure; executive function; memory; risk factor.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Pressure / physiology*
  • Cognition / physiology*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / etiology*
  • Cognitive Dysfunction / physiopathology
  • Diastole
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Hypertension / physiopathology*
  • Incidence
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Population Surveillance*
  • Prospective Studies
  • Risk Factors