Data from: 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%) diastolic OHYPO
and 462 (21.7%) developed dementia. After adjustment for demographics,
seated systolic BP (SBP), antihypertensive drugs, cerebrovascular disease,
diabetes, depressive symptoms, smoking, alcohol, body mass index and
presence of 1 or 2 APOE ε4 alleles, systolic OHYPO was associated with
greater dementia risk (adjusted HR = 1.37, 95% CI 1.01-1.88) unlike
diastolic OHYPO and OHYPO. SBP postural changes variability was also
associated with higher dementia risk (highest tertile of variability (CV):
adjusted HR = 1.35, 95% CI 1.06-1.71). Conclusion: Systolic OHYPO and
visit-to-visit SBP postural changes variability were associated with
greater dementia risk. Our findings raise the question of potential
preventive interventions to control orthostatic SBP and its fluctuations.