Correlation between home systolic blood pressure variability and cognitive impairment in maintenance hemodialysis patients

Abstract In large-scale clinical studies, age, arterial hypertension (AH), multi-focal atherosclerosis, and cognitive disorders (CD) are interrelated, affecting the level of disability, quality of life, and social adaptation of patients with cardiovascular diseases. Aim of the study To determine the prognostic criteria for cognitive disorders in patients with hypertension. Methods To achieve the aim of the study, the examinations were performed in 182 outpatients with AH II stage, 34–68 years, in 164 of them were CD according to neuropsychological tests of MMSE and MoCA, mostly of mild and moderate degree. The relationship between clinical data, cognitive function characteristics and daily monitoring data of hypertension were evaluated. The data obtained were analyzed using medical methods statistics. Results Among factors such as age (>60 years), gender (male / female), disease duration (>10 years), waist circumference, overweight or obesity, hypercholesterolemia, no influence on the development of CD was detected (p>0.05)). Risk factors for the development of CD in hypertension were an burdensome history of CD in closest relatives (2.79 (95% CI 1.15–6.77) relative to practically healthy individuals and 2.41 (1.01–5.88)), high vegetative index (rs +0,15; p<0,05). The correlation between CD and high rates of blood pressure variability according to daily monitoring of blood pressure in patients with hypertension, even under conditions of blood pressure control, is confirmed by the results of correlation and one-factor logit analysis. Thus, elevated levels of systolic blood pressure variability in the day and at night increased the chances of developing CD in patients with hypertension by 2.11 times, (rs = +0.57 and rs = +0.61; p<0.001). It was found that the likelihood of developing cognitive impairment exceeds 50% (high risk) if the level of systolic blood pressure variability is above 12 mm Hg in the day (area under ROC curve AUC = 0.891; 95% CI 0.883–0.940. (AUC = 0.891; 95% CI 0.883–0.940; ST = 82.5% and SP = 92.9%) and at night over 10 mm Hg (AUC = 0.922; 95% CI 0.861–0.963; ST = 82.5% and SP = 85.7%) according to daily blood pressure monitoring. Conclusion The prognosis for the development of cognitive impairment in arterial hypertension is influenced by: evidence of family CD history, autonomic nervous system index and variability of day and night blood pressure characteristics, according to ambulatory daily monitoring data. Funding Acknowledgement Type of funding source: None

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A0053 A Correlation Study of Anti-hypertensive Therapy and Visit-to-Visit Blood Pressure Variability in Maintenance Hemodialysis Patients

Journal of Hypertension ◽

10.1097/01.hjh.0000548374.84775.f0 ◽

2018 ◽

Vol 36 ◽

pp. e94

Author(s):

Lin Yan ◽

Huang Zena

Keyword(s):

Blood Pressure ◽

Blood Pressure Variability ◽

Correlation Study ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Hypertensive Therapy ◽

Maintenance Hemodialysis Patients

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Long-Term Predialysis Systolic Blood Pressure Variability and Intradialytic Cardiac Hemodynamics in Hemodialysis Patients

10.21203/rs.3.rs-112584/v1 ◽

2020 ◽

Author(s):

Jingjuan Yang ◽

Jian Huang ◽

Biying Yu ◽

Qian Zhang ◽

Shanshan Zhang ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Confidence Intervals ◽

Blood Pressure Variability ◽

Hemodialysis Patients ◽

Rate Pressure Product ◽

Intradialytic Hypotension ◽

Cardiac Hemodynamics ◽

Systolic Blood Pressure Variability

Abstract The association in hemodialysis patients between long-term predialysis blood pressure variability and intradialytic cardiac hemodynamics was assessed prospectively in 1070 patients receiving maintenance hemodialysis for more than 3 months. Predialysis blood pressure variability was assessed over 1-year intervals. Outcomes included factors were intradialytic hypotension and change in rate-pressure product. The final cohort’s mean age was 59 years, and 57% were males. Greater predialysis systolic blood pressure variability was associated with an increased risk of intradialytic hypotension (adjusted hazard ratio, 1.097; 95% confidence intervals 1.055 to 1.140) and change in rate-pressure product (adjusted hazard ratio, 1.213; 95% confidence intervals 1.163 to 1.265). Results were similar when blood pressure variability was stratified by baseline systolic blood pressure. Factors associated with higher systolic blood pressure variability were older age, female sex, longer duration of dialysis, and diagnosis of diabetic nephropathy, and lower levels of serum albumin. In conclusion, greater predialysis systolic blood pressure variability among hemodialysis patients was associated with greater intradialytic cardiac hemodynamic instability. Strategies to reduce blood pressure variability might be beneficial for hemodialysis patients.

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Long-Term Blood Pressure Variability Across the Clinical and Biomarker Spectrum of Alzheimer’s Disease

Journal of Alzheimer s Disease ◽

10.3233/jad-200221 ◽

2020 ◽

Vol 77 (4) ◽

pp. 1655-1669

Author(s):

Isabel J. Sible ◽

Daniel A. Nation ◽

Keyword(s):

Alzheimer’S Disease ◽

Blood Pressure ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Cognitively Normal ◽

Systolic Blood Pressure Variability

Background: Elevated blood pressure is linked to cognitive impairment and Alzheimer’s disease (AD) biomarker abnormality. However, blood pressure levels vary over time. Less is known about the role of long-term blood pressure variability in cognitive impairment and AD pathophysiology. Objective: Determine whether long-term blood pressure variability is elevated across the clinical and biomarker spectrum of AD. Methods: Alzheimer’s Disease Neuroimaging Initiative participants (cognitively normal, mild cognitive impairment, AD [n = 1,421]) underwent baseline exam, including blood pressure measurement at 0, 6, and 12 months. A subset (n = 318) underwent baseline lumbar puncture to determine cerebrospinal fluid amyloid-β and phosphorylated tau levels. Clinical groups and biomarker-confirmed AD groups were compared on blood pressure variability over 12 months. Results: Systolic blood pressure variability was elevated in clinically diagnosed AD dementia (VIM: F2,1195 = 6.657, p = 0.001, η2 = 0.01) compared to cognitively normal participants (p = 0.001), and in mild cognitive impairment relative to cognitively normal participants (p = 0.01). Findings were maintained in biomarker-confirmed AD (VIM: F2,850 = 5.216, p = 0.006, η2 = 0.01), such that systolic blood pressure variability was elevated in biomarker-confirmed dementia due to AD relative to cognitively normal participants (p = 0.005) and in biomarker-confirmed mild cognitive impairment due to AD compared to cognitively normal participants (p = 0.04). Conclusion: Long-term systolic blood pressure variability is elevated in cognitive impairment due to AD. Blood pressure variability may represent an understudied aspect of vascular dysfunction in AD with potential clinical implications.

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Influence of intradialytic systolic blood pressure changes on arteriovenous access thrombosis in maintenance hemodialysis patients

International Journal of Clinical Practice ◽

10.1111/ijcp.13799 ◽

2020 ◽

Author(s):

Cai‐Mei Zheng ◽

Yi‐Ping Chiu ◽

Yi‐Chou Hou ◽

Yueh‐Min Liu ◽

Mai‐Szu Wu ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Arteriovenous Access ◽

Pressure Changes ◽

Maintenance Hemodialysis Patients

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SYSTOLIC BLOOD PRESSURE VARIABILITY DURING MECHANICAL THROMBECTOMY IS ASSOCIATED WITH EARLY NEUROLOGICAL DETERIORATION IN ACUTE ISCHEMIC STROKE PATIENTS

10.26226/morressier.58e389aed462b80292385662 ◽

2017 ◽

Author(s):

João Pedro Marto

Keyword(s):

Blood Pressure ◽

Ischemic Stroke ◽

Systolic Blood Pressure ◽

Acute Ischemic Stroke ◽

Blood Pressure Variability ◽

Mechanical Thrombectomy ◽

Neurological Deterioration ◽

Stroke Patients ◽

Early Neurological Deterioration ◽

Systolic Blood Pressure Variability

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Long term habitual vigorous physical activity is associated with lower visit-to-visit systolic blood pressure variability

American Journal of Hypertension ◽

10.1093/ajh/hpaa198 ◽

2020 ◽

Author(s):

Xiaoyong Xu ◽

Xianghong Meng ◽

Shin-ichi Oka

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Standard Deviation ◽

Systolic Blood Pressure ◽

Blood Pressure Variability ◽

Vigorous Physical Activity ◽

Systolic Blood Pressure Variability ◽

Average Real Variability ◽

Post Hoc

Abstract Objective Our work aimed to investigate the association between vigorous physical activity and visit-to-visit systolic blood pressure variability (BPV). Methods We conducted a post hoc analysis of SPRINT (Systolic Blood Pressure Intervention Trial), a well-characterized cohort of participants randomized to intensive (<120 mmHg) or standard (<140 mmHg) SBP targets. We assessed whether patients with hypertension who habitually engage in vigorous physical activity would have lower visit-to-visit systolic BPV compared with those who do not engage in vigorous physical activity. Visit-to-visit systolic BPV was calculated by standard deviation (SD), average real variability (ARV), and standard deviation independent of the mean (SDIM) using measurements taken during the 1-, 2-, 3-, 6-, 9- and 12-month study visits. A medical history questionnaire assessed vigorous physical activity, which was divided into three categories according to the frequency of vigorous physical activity. Results A total of 7571 participants were eligible for analysis (34.8% female, mean age 67.9±9.3 years). During a follow-up of 1-year, vigorous physical activity could significantly reduce SD, ARV, and SDIM across increasing frequency of vigorous physical activity. There were negative linear trends between frequency of vigorous physical activity and visit-to-visit systolic BPV. Conclusions Long-term engagement in vigorous physical activity was associated with lower visit-to-visit systolic BPV.

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