Article

Blood pressure and memory in older African Americans

Department of Psychology and Neuroscience, Duke University, Durham, North Carolina 22708, USA.
Ethnicity & disease (Impact Factor: 1). 02/2008; 18(2):181-6.
Source: PubMed

ABSTRACT

The rates of high blood pressure among African Americans, as a group, are the highest in the world. The implications for higher average blood pressure include complications for many major chronic conditions, such as cardiovascular disease and diabetes. Less well studied is the effect of blood pressure on the cognitive functioning of African Americans. The purpose of this study was to examine the effect of blood pressure on memory measures in a sample of adult African Americans. Analyses were conducted on a sample of 361 African American adults (mean age 61.50 years, standard deviation 9.39 years). We found significant correlations between systolic blood pressure and most cognitive measures but only for one of the measures and diastolic blood pressure. Regressions revealed significant effects for systolic blood pressure on Digit Symbol, Telephone Interview of Cognitive Status, and Immediate Recall on the Wechsler Logical Memory test. These findings suggest that blood pressure is a source of individual variability in cognitive aging among African Americans.

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    • "Elevated blood pressure (BP) is a significant risk factor for cerebrovascular disease (CVD), and it is becoming more prevalent as the population grows proportionally older and more sedentary. Complications arising from high BP are more widespread in African American communities relative to other racial groups (Howard et al., 2006; Taylor et al., 2008), and there is evidence to suggest that, as a group, African Americans are more susceptible to the serious consequences of CVD, such as stroke and vascularrelated cognitive decline (Singh, Cohen, Krupp, & Abedi, 1998; Whitfield et al., 2008). It is possible that this increased susceptibility to vascular events may also result in heightened risk for more subtle brain changes and neuropsychological impairment. "
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    ABSTRACT: We examined how wide ranges in levels of risk factors for cerebrovascular disease are associated with thickness of the human cerebral cortex in 115 individuals ages 43-83 with no cerebrovascular or neurologic history. Cerebrovascular risk factors included blood pressure, cholesterol, body mass index, creatinine, and diabetes-related factors. Variables were submitted into a principal components analysis that confirmed four orthogonal factors (blood pressure, cholesterol, cholesterol/metabolic and glucose). T1-weighted MRI was used to create models of the cortex for calculation of regional cortical thickness. Increasing blood pressure factor scores were associated with numerous regions of reduced thickness. Increasing glucose scores were modestly associated with areas of regionally decreased thickness. Increasing cholesterol scores, in contrast, were associated with thicker cortex across the whole brain. All findings were primarily independent of age. These results provide evidence that normal and moderately abnormal levels of parameters used to assess cerebrovascular health may impact brain structure, even in the absence of cerebrovascular disease. Our data have important implications for the clinical management of vascular health, as well as for what is currently conceptualized as "normal aging" as they suggest that subclinical levels of risk may impact cortical gray matter before a disease process is evident.
    Full-text · Article · Oct 2010 · NeuroImage
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    • "Elevated blood pressure (BP) is a significant risk factor for cerebrovascular disease (CVD), and it is becoming more prevalent as the population grows proportionally older and more sedentary. Complications arising from high BP are more widespread in African American communities relative to other racial groups (Howard et al., 2006; Taylor et al., 2008), and there is evidence to suggest that, as a group, African Americans are more susceptible to the serious consequences of CVD, such as stroke and vascularrelated cognitive decline (Singh, Cohen, Krupp, & Abedi, 1998; Whitfield et al., 2008). It is possible that this increased susceptibility to vascular events may also result in heightened risk for more subtle brain changes and neuropsychological impairment. "
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    ABSTRACT: Although hypertension is a major risk factor for cerebrovascular disease (CVD) and is highly prevalent in African Americans, little is known about how blood pressure (BP) affects brain-behavior relationships in this population. In predominantly Caucasian populations, high BP is associated with alterations in frontal-subcortical white matter and in executive functioning aspects of cognition. We investigated associations among BP, brain structure, and neuropsychological functioning in 52 middle-older-age African Americans without diagnosed history of CVD. All participants underwent diffusion tensor imaging for examination of white matter integrity, indexed by fractional anisotropy (FA). Three regions of interest were derived in the anterior (genu) and posterior (splenium) corpus callosum and across the whole brain. A brief neuropsychological battery was administered from which composite scores of executive function and memory were derived. Blood pressure was characterized by mean arterial blood pressure (MABP). When controlling for age, higher MABP was associated with lower FA in the genu, and there was a trend for this same relationship with regard to whole-brain FA. When the sample was broken into groups on the basis of treatment for BP regulation (medicated vs. nonmedicated), MABP was related to genu and whole-brain FA only in the nonmedicated group. Neither MABP nor FA was significantly related to either neuropsychological composite score regardless of medication use. These data provide important evidence that variation in BP may contribute to significant alterations in specific neural regions of white matter in nonmedicated individuals without symptoms of overt CVD.
    Full-text · Article · Mar 2010 · Neuropsychology
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