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Systolic Blood Pressure within an Intermediate Range May Reduce Memory Loss in an Elderly Hypertensive Cohort

Sarah Gray, PhD

Claudia Kawas, MD

Jeffrey Herbst, PhD

Paul Costa, PhD

Jerome Fleg, MD

The objective of this study was to determine if maintenance of systolic blood pressure (BP) within a high range or low range among treated hypertensive patients increases the risk of memory decline. Biennial neuropsychological evaluations were performed on 158 hypertensive subjects. Decline/year was measured on the Cued Selective Reminding test (total free recall and delayed recall) in three systolic BP groups (low—i.e., mean systolic BP during the follow-up period < 135 mm Hg; intermediate—i.e., 135 mm Hg mean systolic BP 150 mm Hg; high—i.e., mean systolic BP > 150 mm Hg). In total free recall, the three systolic BP groups had significantly different declines per year (P = .02), with patients in the high subgroup showing the greatest decline. In delayed recall, the three sys tolic BP groups also showed significantly different declines per year (P = .04), with patients in the low subgroup having the greatest decline. Chronically elevated systolic BP > 150 mm Hg is associated with accelerated memory decline compared to older treated hypertensive patients with systolic BP in an intermediate range. Chronically maintained systolic BP within a low normal range < 135 mm Hg in older treated hypertensive subjects may be asso ciated with accelerated memory decline, specifically in a test of delayed memory recall, compared to patients with systolic BP in an intermediate range. Optimal regulation of systolic BP may be a potential modifiable risk factor to prevent or minimize memory loss in older hypertensive patients. (J Geriatr Psychiatry Neurol 1999; 12:1-6).

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