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A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study.
J Am Geriatr Soc 2008; 56(8):1449-58JA

Abstract

OBJECTIVES

To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS).

DESIGN

Prospective analyses.

SETTING

Thirty-nine centers.

PARTICIPANTS

Seven thousand one hundred forty-nine women aged 65 and older.

MEASUREMENTS

The Modified Mini-Mental State Examination (3MS) was used to assess global cognitive functioning. Participants who scored below pre-established cutpoints were scheduled for more-extensive neurocognitive assessments. Results from these assessments were centrally adjudicated.

RESULTS

The mean age of this group of 7,149 participants at baseline was 71.0 +/- 3.8, and the mean 3MS score was 95.2 +/- 4.3. During a mean follow-up period of 4.5 years, women without hypertension tended to have slightly higher 3MS scores than women with hypertension (P=.001), but the difference was not seen after adjustment for covariates (P=.17). Women with hypertension also appeared to be at greater risk for probable dementia or mild cognitive impairment (MCI) (hazard ratio=1.35, 95% confidence interval=1.07-1.70, P=.01), although when potential cofounders were accounted for, this association was no longer significant (P=.06).

CONCLUSION

Hypertension and high blood pressure at baseline were not independently associated with MCI or probable dementia over time in older, cognitively intact, postmenopausal women enrolled in WHIMS after other potential confounders were taken into account. These analyses should not be viewed as discouraging appropriate medical treatment for hypertension.

Authors+Show Affiliations

Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennesse 38163, USA. Kjohnson@utmem.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18637980

Citation

Johnson, Karen C., et al. "A Prospective Study of the Effect of Hypertension and Baseline Blood Pressure On Cognitive Decline and Dementia in Postmenopausal Women: the Women's Health Initiative Memory Study." Journal of the American Geriatrics Society, vol. 56, no. 8, 2008, pp. 1449-58.
Johnson KC, Margolis KL, Espeland MA, et al. A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study. J Am Geriatr Soc. 2008;56(8):1449-58.
Johnson, K. C., Margolis, K. L., Espeland, M. A., Colenda, C. C., Fillit, H., Manson, J. E., ... Wassertheil-Smoller, S. (2008). A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study. Journal of the American Geriatrics Society, 56(8), pp. 1449-58. doi:10.1111/j.1532-5415.2008.01806.x.
Johnson KC, et al. A Prospective Study of the Effect of Hypertension and Baseline Blood Pressure On Cognitive Decline and Dementia in Postmenopausal Women: the Women's Health Initiative Memory Study. J Am Geriatr Soc. 2008;56(8):1449-58. PubMed PMID: 18637980.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A prospective study of the effect of hypertension and baseline blood pressure on cognitive decline and dementia in postmenopausal women: the Women's Health Initiative Memory Study. AU - Johnson,Karen C, AU - Margolis,Karen L, AU - Espeland,Mark A, AU - Colenda,Christopher C, AU - Fillit,Howard, AU - Manson,Joann E, AU - Masaki,Kamal H, AU - Mouton,Charles P, AU - Prineas,Ronald, AU - Robinson,Jennifer G, AU - Wassertheil-Smoller,Sylvia, AU - ,, Y1 - 2008/07/15/ PY - 2008/7/22/pubmed PY - 2008/10/7/medline PY - 2008/7/22/entrez SP - 1449 EP - 58 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 56 IS - 8 N2 - OBJECTIVES: To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS). DESIGN: Prospective analyses. SETTING: Thirty-nine centers. PARTICIPANTS: Seven thousand one hundred forty-nine women aged 65 and older. MEASUREMENTS: The Modified Mini-Mental State Examination (3MS) was used to assess global cognitive functioning. Participants who scored below pre-established cutpoints were scheduled for more-extensive neurocognitive assessments. Results from these assessments were centrally adjudicated. RESULTS: The mean age of this group of 7,149 participants at baseline was 71.0 +/- 3.8, and the mean 3MS score was 95.2 +/- 4.3. During a mean follow-up period of 4.5 years, women without hypertension tended to have slightly higher 3MS scores than women with hypertension (P=.001), but the difference was not seen after adjustment for covariates (P=.17). Women with hypertension also appeared to be at greater risk for probable dementia or mild cognitive impairment (MCI) (hazard ratio=1.35, 95% confidence interval=1.07-1.70, P=.01), although when potential cofounders were accounted for, this association was no longer significant (P=.06). CONCLUSION: Hypertension and high blood pressure at baseline were not independently associated with MCI or probable dementia over time in older, cognitively intact, postmenopausal women enrolled in WHIMS after other potential confounders were taken into account. These analyses should not be viewed as discouraging appropriate medical treatment for hypertension. SN - 1532-5415 UR - https://www.unboundmedicine.com/medline/citation/18637980/A_prospective_study_of_the_effect_of_hypertension_and_baseline_blood_pressure_on_cognitive_decline_and_dementia_in_postmenopausal_women:_the_Women's_Health_Initiative_Memory_Study_ L2 - https://doi.org/10.1111/j.1532-5415.2008.01806.x DB - PRIME DP - Unbound Medicine ER -