Deborah A. Levine|Alden L. Gross|Emily M. Briceño|Nicholas Tilton|Mohammed U. Kabeto|Stephanie Hingtgen|Bruno Giordani|Jeremy B. Sussman|Rodney A. Hayward|James F. Burke|Mitchell S.V. Elkind|Jennifer J. Manly|Andrew E. Moran|Erin R. Kulick|Rebecca F. Gottesman|Keenan A. Walker|Yuichiro Yano|Darrell J. Gaskin|Stephen Sidney|Kristine Yaffe|Ralph L. Sacco|Clinton B. Wright|Véronique L. Roger|Norrina B. Allen|Andrzej T. Ga?ecki
Association Between Blood Pressure and Later-Life Cognition Among Black and White Individuals
University of Michigan–Ann Arbor|Johns Hopkins University|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System|University of Michigan–Ann Arbor|University of Michigan–Ann Arbor|VA Ann Arbor Healthcare System|Columbia University|Columbia University|Columbia University|Providence College|Brown University|Johns Hopkins University|Johns Hopkins University|Duke University|Johns Hopkins University|Kaiser Permanente|University of California, San Francisco|University of Miami|National Institute of Neurological Disorders and Stroke|Mayo Clinic in Florida|Northwestern University|University of Michigan–Ann Arbor
importance black individuals likely white individuals develop dementia whether higher blood pressure bp levels black individuals explain differences black white individuals dementia risk uncertain objective determine whether cumulative bp levels explain racial differences cognitive decline design setting participants individual participant data 5 cohorts january 1971 december 2017 pooled atherosclerosis risk communities study coronary artery risk development young adults study cardiovascular health study framingham offspring study northern manhattan study outcomes standardized scores mean sd 50 10 1point difference represented 01sd difference cognition median interquartile range followup 124 59210 years analysis began september 2018 main outcomes measures primary outcome change global cognition secondary outcomes change memory executive function exposures race black vs white results among 34 349 participants 19 378 individuals free stroke dementia longitudinal bp cognitive covariate data included analysis mean sd age first cognitive assessment 598 104 years ranged 5 95 years 19 378 individuals 10 724 553 female 15 526 801 white compared white individuals black individuals significantly faster declines global cognition 003 points per year faster 95 ci 005 001 p 004 memory 008 points per year faster 95 ci 011 006 p ampamplt 001 significantly slower declines executive function 009 points per year slower 95 ci 008010 p ampamplt 001 timedependent cumulative mean systolic bp level associated significantly faster declines global cognition 0018 points per year faster per 10mm hg increase 95 ci 0023 0014 p ampamplt 001 memory 0028 points per year faster per 10mm hg increase 95 ci 0035 0021 p ampamplt 001 executive function 001 points per year faster per 10mm hg increase 95 ci 0014 0007 p ampamplt 001 adjusting cumulative mean systolic bp differences black white individuals cognitive slopes attenuated global cognition 001 points per year 95 ci 003 001 p 56 memory 006 points per year 95 ci 008 003 p ampamplt 001 executive function 010 points per year 95 ci 009011 p ampamplt 001 conclusions relevance results suggest black individuals higher cumulative bp levels may contribute racial differences laterlife cognitive decline