Blood Pressure and All‐Cause Mortality by Level of Cognitive Function in the Elderly: Results From a Population‐Based Study in Rural Greece |
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| Authors: | Marios K. Georgakis MD Athanasios D. Protogerou MD PhD Eleni I. Kalogirou MD Evangelia Kontogeorgi MD Ioanna Pagonari MD Fani Sarigianni MD Sokratis G. Papageorgiou MD PhD Elisabeth Kapaki MD PhD Charalampos Papageorgiou MD PhD Dimitrios Tousoulis MD PhD Eleni Th. Petridou MD MPH PhD |
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| Affiliation: | 1. Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;2. Cardiovascular Prevention and Research Unit, Department of Pathophysiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;3. Health Centre of Velestino, Ahillopouleio General Hospital of Volos, Velestino, Volos, Greece;4. Second Department of Neurology, Attikon University General Hospital, School of Medicine, National and Kapodistrian University of Athens, Chaidari, Athens, Greece;5. First Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;6. First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece;7. First Department of Cardiology, Hippokrateion Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece |
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| Abstract: | This study aimed to investigate whether the effect of blood pressure (BP) on mortality differs by levels of cognitive function. The associations of brachial systolic BP, diastolic BP, mean arterial pressure (MAP), and pulse pressure with all‐cause mortality were prospectively explored (follow‐up 7.0±2.2 years) in 660 community‐dwelling individuals ( ≥ 60 years) using adjusted Cox models, stratified by cognitive impairment (Mini‐Mental State Examination [MMSE] <24). No association between brachial BP variables and mortality was shown for the total sample in quartiles analysis; however, MAP in the highest quartile, compared with the second, was associated with mortality (hazard ratio, 1.85; 95% confidence intervals, 1.09–3.12) among cognitively impaired individuals. The fractional‐polynomials approach for BP confirmed this finding and further showed, solely in the MMSE <24 subcohort, U‐shaped trends of MAP and systolic BP, with increased mortality risk in extremely low or high values; no such pattern was evident for patients with MMSE ≥24. Elderly individuals with cognitive impairment might be more susceptible to the detrimental effects of low and elevated MAP and systolic BP. |
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