@article{21348,
  keywords = {Female, Humans, Aged, Follow-Up Studies, Male, Middle Aged, Risk Factors, Predictive Value of Tests, Drug Therapy, Combination, Incidence, Aged, 80 and over, Randomized Controlled Trials as Topic, Cardiovascular Diseases/ epidemiology, Blood Pressure/ physiology, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Antihypertensive Agents/therapeutic use, Benzimidazoles/therapeutic use, Benzoates/therapeutic use, Cognition Disorders/ epidemiology, Heart Rate/ physiology, Hypertension/ complications/drug therapy/ physiopathology, Multivariate Analysis, Ramipril/therapeutic use, Retrospective Studies},
  author = {Teo K. and Unger T. and Schumacher H. and Sleight P. and Diener H. and O'Donnell M. and Lonn E. and Redon J. and Fagard R. and Sliwa K. and Schmieder R. and Anderson Craig and Mancia G. and Böhm M. and Yusuf S. and Leong D. and Custodis F. and Laufs U.},
  title = {Systolic blood pressure variation and mean heart rate is associated with cognitive dysfunction in patients with high cardiovascular risk},
  abstract = {<p>
Elevated systolic blood pressure (SBP) correlates to cognitive decline and incident dementia. The effects of heart rate (HR), visit to visit HR variation, and visit to visit SBP variation are less well established. Patients without preexisting cognitive dysfunction (N=24 593) were evaluated according to mean SBP, SBP visit to visit variation (coefficient of variation [standard deviation/meanx100%], CV), mean HR, and visit to visit HR variation (HR-CV) in the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial and the Telmisartan Randomized Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease. Cognitive function was assessed with mini mental state examination. Cognitive dysfunction (fall in mini mental state examination <!--=24 points), important cognitive decline (drop of -->/=5 points), and cognitive deterioration (drop of &gt;1 point per year or decline to &lt;24 points) were assessed. SBP and HR were measured over 10.7+/-2.2 (mean+/-SD) visits. Mean SBP, mean HR, and SBP-CV were associated with cognitive decline, dysfunction, and deterioration (all P&lt;0.01, unadjusted). After adjustment, only SBP-CV (P=0.0030) and mean HR (P=0.0008) remained predictors for cognitive dysfunction (odds ratios [95% confidence intervals], 1.32 [1.10-1.58] for 5th versus 1st quintile of SBP-CV and 1.40 [1.18-1.66] for 5th versus 1st quintile of mean HR). Similar effects were observed for cognitive decline and deterioration. SBP-CV and mean HR showed additive effects. In conclusion, SBP-CV and mean HR are independent predictors of cognitive decline and cognitive dysfunction in patients at high CV risk. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT 00153101.
</p>
},
  year = {2015},
  journal = {Hypertension},
  volume = {65},
  edition = {2015/01/15},
  number = {3},
  pages = {651-61},
  isbn = {1524-4563 (Electronic)<br/>0194-911X (Linking)},
  note = {Bohm, Michael<br/>Schumacher, Helmut<br/>Leong, Darryl<br/>Mancia, Giuseppe<br/>Unger, Thomas<br/>Schmieder, Roland<br/>Custodis, Florian<br/>Diener, Hans-Christoph<br/>Laufs, Ulrich<br/>Lonn, Eva<br/>Sliwa, Karen<br/>Teo, Koon<br/>Fagard, Robert<br/>Redon, Josep<br/>Sleight, Peter<br/>Anderson, Craig<br/>O'Donnell, Martin<br/>Yusuf, Salim<br/>Research Support, Non-U.S. Gov't<br/>United States<br/>Hypertension. 2015 Mar;65(3):651-61. doi: 10.1161/HYPERTENSIONAHA.114.04568. Epub 2015 Jan 12.},
  language = {eng},
}