Blood Pressure and Later-Life Cognition in Hispanic and White Adults (BP-COG): A Pooled Cohort Analysis of ARIC, CARDIA, CHS, FOS, MESA, and NOMAS

Overview

Journal J Alzheimers Dis

Publisher Sage Publications

Specialties Geriatrics
Neurology

Date 2022 Aug 14

PMID 35964190

Authors

Deborah A Levine

Alden L Gross

Emily M Briceno

Nicholas Tilton

Rachael Whitney

Dehua Han

Bruno J Giordani

Jeremy B Sussman

Rodney A Hayward

James F Burke

Mitchell S V Elkind

Andrew E Moran

Sarah Tom

Rebecca F Gottesman

Darrell J Gaskin

Stephen Sidney

Kristine Yaffe

Ralph L Sacco

Susan R Heckbert

Timothy M Hughes

Oscar L Lopez

Norrina Bai Allen

Andrzej T Galecki

Affiliations

Soon will be listed here.

Abstract

Background: Ethnic differences in cognitive decline have been reported. Whether they can be explained by differences in systolic blood pressure (SBP) is uncertain.

Objective: Determine whether cumulative mean SBP levels explain differences in cognitive decline between Hispanic and White individuals.

Methods: Pooled cohort study of individual participant data from six cohorts (1971-2017). The present study reports results on SBP and cognition among Hispanic and White individuals. Outcomes were changes in global cognition (GC) (primary), executive function (EF) (secondary), and memory standardized as t-scores (mean [SD], 50 [10]); a 1-point difference represents a 0.1 SD difference in cognition. Median follow-up was 7.7 (Q1-Q3, 5.2-20.1) years.

Results: We included 24,570 participants free of stroke and dementia: 2,475 Hispanic individuals (median age, cumulative mean SBP at first cognitive assessment, 67 years, 132.5 mmHg; 40.8% men) and 22,095 White individuals (60 years,134 mmHg; 47.3% men). Hispanic individuals had slower declines in GC, EF, and memory than White individuals when all six cohorts were examined. Two cohorts recruited Hispanic individuals by design. In a sensitivity analysis, Hispanic individuals in these cohorts had faster decline in GC, similar decline in EF, and slower decline in memory than White individuals. Higher time-varying cumulative mean SBP was associated with faster declines in GC, EF, and memory in all analyses. After adjusting for time-varying cumulative mean SBP, differences in cognitive slopes between Hispanic and White individuals did not change.

Conclusion: We found no evidence that cumulative mean SBP differences explained differences in cognitive decline between Hispanic and White individuals.

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