Systolic blood pressure postural changes variability is associated with greater dementia risk

Objective: To determine whether orthostatic hypotension (OHYPO) and visit-to-visit blood pressure (BP) postural changes variability are associated with incident dementia.
Methods: We studied 2,131 older adults from the Health, Aging, Body Composition cohort study. Orthostatic BP was repeatedly assessed over a 5-year baseline period. OHYPO was defined as a fall ≥ 15 mmHg in systolic or ≥ 7 mmHg in diastolic BP after standing from a sitting position for ≥ 1/3 of visits. Systolic and diastolic OHYPO were also examined separately. BP postural changes variability over time was evaluated using several indicators including standard deviation and coefficient of variation (CV). Incident dementia was determined over 12 years following the baseline period by dementia medication use, ≥ 1.5 SD decline in Modified Mini-Mental State or hospitalization records.
Results: Of 2,131 participants (mean age 73 years, 53% female, 39% black), 309 (14.5%) had OHYPO, 192 (9.0%) systolic OHYPO, 132 (6.2%) diastol...

研究目标：明确体位性低血压（orthostatic hypotension, OHYPO）与多次随访间血压（blood pressure, BP）体位变化变异性是否与新发痴呆相关。
方法：本研究纳入来自健康、衰老与身体成分队列研究（Health, Aging, Body Composition cohort study）的2131名老年受试者。在为期5年的基线随访期内，重复测量受试者的体位性血压。体位性低血压的判定标准为：从坐位站起后，收缩压下降≥15mmHg或舒张压下降≥7mmHg，且该情况出现于≥1/3的随访次数中。本研究同时分别评估了收缩压型体位性低血压与舒张压型体位性低血压。采用标准差与变异系数（coefficient of variation, CV）等多项指标，评估随时间推移的血压体位变化变异性。在基线随访结束后的12年随访期内，通过受试者的痴呆用药史、改良迷你精神状态量表（Modified Mini-Mental State）得分较基线下降≥1.5个标准差，或是住院记录，判定新发痴呆病例。
结果：在2131名受试者（平均年龄73岁，53%为女性，39%为黑人）中，309人（14.5%）存在体位性低血压，192人（9.0%）为收缩压型体位性低血压，132人（6.2%）为舒张压型...