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. 2023 Jan-Dec:38:15333175231172283.
doi: 10.1177/15333175231172283.

Diastolic Blood Pressure and Cognitive Functioning: Differences by Systolic Blood Pressure Among US Adults

A Mathew  1 , R A Mesa  1 , L Nahodyl  1 , J Tremblay  1 , T Rundek  2 , A Zeki Al Hazzouri  3 , T Elfassy  4
Affiliations

Diastolic Blood Pressure and Cognitive Functioning: Differences by Systolic Blood Pressure Among US Adults

A Mathew et al. Am J Alzheimers Dis Other Demen. 2023 Jan-Dec.

Abstract

Background: The role of diastolic blood pressure (DBP) with cognitive functioning is under-explored in relation to levels of systolic blood pressure (SBP).

Methods: We studied 5466 participants from the National Health and Nutrition Examination Survey. Blood pressure was measured 3 times manually with a standardized sphygmomanometer and averaged. Cognitive functioning was measured using the digit symbol substitution test (DSST).

Results: Participants were 60 years or older, 55% female, and 81% non-Hispanic White. Most participants had a DBP between 70 to <80 mmHg (33.7%), between 60 to <70 mmHg (29.3%), or <60 mmHg (18.8%). From multivariable linear regression analyses, each 5 mmHg increment of DBP was associated with significantly higher DSST scores among individuals with SBP <120 only (ß: 0.56, 95% CI: 0.09, 1.03).

Conclusions: Among older US adults, at non-elevated levels of SBP, higher DBP is associated with better cognitive performance.

Keywords: blood pressure; cognition; diastolic blood pressure; executive function; older adults.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Distribution of DBP among US adults age 60 and older, stratified by SBP. Abbreviations DBP: Diastolic blood pressure; SBP: Systolic blood pressure there are no individuals SBP <120 mmHg and DBP ≥90 mmHg.
Figure 2.
Figure 2.
Association between SBP and DSST, overall and according to categories of DBP. Abbreviations DBP: Diastolic blood pressure; DSST: Digit Symbol Substitution Test; SBP: Systolic blood pressure. *Indicates estimate is significant (P < .05) Models are adjusted for age, sex, race/ethnicity, education, income, marital status, health insurance, alcohol use, smoking, physical activity, self-rated general health, blood pressure medication, body mass index, diabetes, and total cholesterol.
See this image and copyright information in PMC

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