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Olle Melander

Principal investigator

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Longitudinal and postural changes of blood pressure predict dementia : the Malmö Preventive Project

Author

  • Hannes Holm
  • Katarina Nägga
  • Erik D. Nilsson
  • Olle Melander
  • Lennart Minthon
  • Erasmus Bachus
  • Artur Fedorowski
  • Martin Magnusson

Summary, in English

The role of blood pressure (BP) changes in dementia is debatable. We aimed to analyse how resting and postural BP changes relate to incident dementia over a long-term follow-up. In the prospective population-based Malmö Preventive Project, 18,240 study participants (mean age: 45 ± 7 years, 63% male) were examined between 1974 and 1992 with resting and standing BP measurement, and re-examined between 2002 and 2006 at mean age of 68 ± 6 years with resting BP. A total of 428 participants (2.3%) were diagnosed with dementia through Dec 31, 2009. The association of resting and postural BP changes with risk of dementia was studied using multivariable-adjusted Cox regression models controlling for traditional risk factors. Diastolic BP (DBP) decrease on standing indicated higher risk of dementia [Hazard ratio (HR) per 10 mmHg: 1.22; 95% confidence interval (CI) 1.01–1.44, p = 0.036], which was mainly driven by increased risk in normotensive individuals. Higher systolic (SBP) and diastolic BP at re-examination was associated with lower risk of dementia (HR per 10 mmHg: 0.94; 95% CI 0.89–0.99, p = 0.011; and 0.87; 0.78–0.96, p = 0.006, respectively). Extreme decrease in SBP/DBP between baseline and re-examination (4th quartile; −7 ± 12/−15 ± 7 mmHg, respectively) indicated higher risk of dementia (HR 1.46; 95% CI 1.11–1.93, p = 0.008, and 1.54; 95% CI 1.14–2.08, p = 0.005; respectively) compared with reference group characterised by pronounced BP increase over the same period (1st quartile; +44 ± 13/+15 ± 7 mmHg). Diastolic BP decrease on standing in the middle age, decline in BP between middle-and advanced age, and lower BP in advanced age are independent risk factors of developing dementia.

Department/s

  • Cardiovascular Research - Hypertension
  • Clinical Memory Research
  • EXODIAB: Excellence in Diabetes Research in Sweden
  • EpiHealth: Epidemiology for Health
  • MultiPark: Multidisciplinary research focused on Parkinson´s disease

Publishing year

2017-02-11

Language

English

Pages

327-336

Publication/Series

European Journal of Epidemiology

Volume

32

Issue

4

Document type

Journal article

Publisher

Springer

Topic

  • Neurology
  • Cardiac and Cardiovascular Systems

Keywords

  • Blood pressure
  • Dementia
  • Orthostatic hypotension
  • Prospective studies
  • Risk factors

Status

Published

Project

  • Prediction, Prevention and Treatment of Progressing Heart Failure and Coincident Cognitive Impairment

Research group

  • Cardiovascular Research - Hypertension
  • Clinical Memory Research

ISBN/ISSN/Other

  • ISSN: 0393-2990