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. 2024 Feb 24:6:100212.
doi: 10.1016/j.cccb.2024.100212. eCollection 2024.

Slower speed of blood pressure recovery after standing is associated with accelerated brain aging: Evidence from The Irish Longitudinal Study on Ageing (TILDA)

Morgana A Shirsath  1 , John D O'Connor  1   2 , Rory Boyle  3 , Louise Newman  1 , Silvin P Knight  1 , Belinda Hernandez  1 , Robert Whelan  4   5 , James F Meaney  6 , Rose Anne Kenny  1
Affiliations

Slower speed of blood pressure recovery after standing is associated with accelerated brain aging: Evidence from The Irish Longitudinal Study on Ageing (TILDA)

Morgana A Shirsath et al. Cereb Circ Cogn Behav. .

Abstract

Background: Impaired recovery of blood pressure (BP) in response to standing up is a prevalent condition in older individuals. We evaluated the relationship between the early recovery of hemodynamic responses to standing and brain health in adults over 50.

Methods: Participants from The Irish Longitudinal Study on Ageing (TILDA) (n=411; age 67.6 ± 7.3 years; 53.4 % women) performed an active stand challenge while blood pressure and heart rate were continuously monitored. The recovery of these parameters was determined as the slope of the BP and HR response, following the initial drop/rise after standing. We have previously reported a novel and validated measure of brain ageing using MRI data, which measures the difference between biological brain age and chronological age, providing a brain-predicted age difference (brainPAD) score.

Results: Slower recovery of systolic and diastolic BP was found to be significantly associated with higher brainPAD scores (i.e., biologically older brains), where a one-year increase in brainPAD was associated with a decrease of 0.02 mmHg/s and 0.01 mmHg/s in systolic and diastolic BP recovery, respectively, after standing. Heart rate (HR) recovery was not significantly associated with brainPAD score.

Conclusion: These results demonstrate that slower systolic and diastolic BP recovery in the early phase after standing is associated with accelerated brain aging in older individuals. This suggests that the BP response to standing, measured using beat-to-beat monitoring, has the potential to be used as a marker of accelerated brain aging, relying on a simple procedure and devices that are easily accessible.

Keywords: Active stand; Brain aging; Cerebral autoregulation; Orthostatic hypotension.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image, graphical abstract
Graphical abstract
Fig 1
Fig. 1
Flowchart of the sample selection. Abbreviations: MRI: Magnetic Resonance Imaging; BrainPAD: Brain-Predicted Age Difference; GM: gray matter; WM: white matter; TIA: transient ischemic attack; BP: blood pressure; HR: heart rate; PWV: pulse wave velocity; MA: minimally adjusted; FA: fully adjusted.
Fig 2
Fig. 2
Calculation of the recovery rate after standing. The recovery rate of SBP was determined as rate of increase in SBP from the nadir until the next peak post standing, where greater positive values mean that the recovery of SBP occurred faster. The same calculations were completed for the recovery rate of DBP and HR. In the case of HR recovery, the slope is negative and greater absolute values mean that the recovery is faster. Abbreviations: SBP: systolic blood pressure.
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