Hypertension Is Related to Cognitive Impairment: A 20-Year Follow-up of 999 Men
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Abstract —Recent findings of a linkage between high blood pressure (BP) and later development of dementia have given new prospects on cerebral target-organ damage in hypertension and have added substance to the concept of “preventable senility.” The aim of this study was to analyze the impact of hypertension, circadian BP profile, and disturbed glucose metabolism on cognitive function. The study population consisted of 999 seventy-year-old men from a population-based cohort study in Uppsala, Sweden, followed with respect to cardiovascular risk factors since the age of 50 years. At the age of 70, 24-hour ambulatory BP was monitored together with measurements of insulin sensitivity, glucose tolerance, serum lipids, and lipoproteins. Cognitive function was assessed by the Mini-Mental State Examination and the Trail-Making Test. High diastolic BP at baseline predicted later impaired cognitive performance, even after excluding men with a previous stroke (n=70). Cross-sectional measurements at age 70 showed that high 24-hour BP, nondipping, insulin resistance, and diabetes all were related to low cognitive function. The relationships between hypertension and cognitive impairment were strongest in untreated men. These data from a general population of healthy elderly men indicate that hypertension and associated metabolic disturbances might be susceptibility factors for cognitive disorders. The findings add support to possibilities of intervention in early stages in cognitive decline, ie, before manifest dementia.
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It cannot be excluded that blood pressure reductions may contribute to supporting cognitive improvements and preventing blood pressure-related cognitive decline over a longer time course.
“However, we cannot exclude that these reductions in blood pressure, in addition to improving cardiovascular health, may contribute to supporting improvements in cognitive performance and even help in the prevention of blood pressure-related cognitive declines across a longer time course.31”
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- Authors
- Kilander, L., Nyman, H., Boberg, M., Hansson, L., & Lithell, H.
- Affiliations
- Karolinska University Hospital (SE)
- From the Department of Geriatrics (L.K., M.B., L.H., H.L.), Uppsala, and the Department of Clinical Neurosciences (H.N.), Karolinska Hospital, Stockholm, Sweden.
- ORCID
- Kilander, Lena
- Venue
- Hypertension
- Published
- 1998-03
- Volume
- 31
- Issue
- 3
- Pages
- 780-786
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2155044939
- Cited by
- 630
- References
- 33
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 13 · 2023: 8 · 2022: 13 · 2021: 22 · 2020: 16 · 2019: 12 · 2018: 16 · 2017: 20 · 2016: 29 · 2015: 37 · 2014: 30 · 2013: 29 · 2012: 26
- FWCI
- 16.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Stiftelsen för Gamla Tjänarinnor
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Keywords
- cognitive impairment, dementia, diastolic blood pressure, circadian blood pressure rhythm, non-dipping blood pressure, insulin resistance, glucose tolerance, diabetes mellitus, 24-hour ambulatory blood pressure, cognitive decline, older men, cardiovascular risk factors
- MeSH terms
- Aged, Blood Pressure, Cerebrovascular Disorders, Cognition Disorders, Cross-Sectional Studies, Follow-Up Studies, Humans, Hypertension, Insulin Resistance, Longitudinal Studies, Male, Risk Factors, Multivariate Analysis, Diabetes Complications
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