Dataset Information

Midlife hypertensive status and cognitive function 20 years later: the Southall and Brent revisited study.

ABSTRACT:

Objectives

To investigate long-term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later.

Design

Cohort study.

Setting

Two areas (Southall and Brent) of northwest London.

Participants

Survey samples of a multiethnic population (European, African Caribbean, South Asian) aged 40 to 67 were followed up 20 years later.

Measurements

Comprehensive cardiovascular assessments were performed at baseline, including measurements of resting blood pressure (BP) and, in a subsample, ambulatory BP. At follow-up, a battery of cognitive assessments was administered, and a composite outcome was derived, with impairment defined as the lowest 10% within each ethnic group. Logistic regression models were used to investigate associations with prior measures of hypertensive status.

Results

In 1,484 participants at follow-up, cognitive impairment showed significant U-shaped associations with baseline diastolic BP (DBP) and mean arterial pressure (MAP; strongest for those aged ≥ 50 at baseline), independent of a range of covariates, but no associations were found with systolic BP or pulse pressure. Cognitive impairment was also associated with antihypertensive medication use and higher evening ambulatory DBP at baseline. No substantial differences in strengths of association were found between ethnic groups.

Conclusion

Low and high DBP and MAP were associated with cognitive impairment 20 years later. Higher evening DBP on ambulatory monitoring was also associated with greater risk.

SUBMITTER: Taylor C

PROVIDER: S-EPMC3902992 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Midlife hypertensive status and cognitive function 20 years later: the Southall and Brent revisited study.

Taylor Clare C Tillin Therese T Chaturvedi Nish N Dewey Michael M Ferri Cleusa P CP Hughes Alun A Prince Martin M Richards Marcus M Shah Ajit A Stewart Robert R

Journal of the American Geriatrics Society 20130826 9

<h4>Objectives</h4>To investigate long-term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later.<h4>Design</h4>Cohort study.<h4>Setting</h4>Two areas (Southall and Brent) of northwest London.<h4>Participants</h4>Survey samples of a multiethnic population (European, African Caribbean, South Asian) aged 40 to 67 were followed up 20 years later.<h4>Measurements</h4>Comprehensive cardiovascular assessments were performed ...[more]

PMID: 24028355

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Project description:Background Image-quality (IQ) compromises left ventricle assessment by 3-dimensional echocardiography (3DE). Sicker/frailer patients often have suboptimal IQ, and therefore observed associations may be biased by IQ. We investigated its effect in an observational study of older people and when IQ was modified experimentally in healthy volunteers. Methods and Results 3DE feasibility by IQ was assessed in 1294 individuals who attended the second wave of the Southall and Brent Revisited study and was compared with 2-dimensional (2D)-echocardiography feasibility in 147 individuals. Upon successful analysis, means of ejection fraction (3D-EF) and global longitudinal strain (3D-GLS) (plus 2D-EF) were compared in individuals with poor versus good IQ. In 2 studies of healthy participants, 3DE-IQ was impaired by (1) intentionally poor echocardiographic technique, and (2) use of a sheet of ultrasound-attenuating material (neoprene rubber; 2-4 mm). The feasibility was 41% (529/1294) for 3DE versus 61% (89/147) for 2D-EF, P<0.0001. Among acceptable images (n=529), good IQ by the 2015 American Society of Echocardiography/European Association of Cardiovascular Imaging criteria was 33.6% (178/529) and 71.3% (377/529) for 3D-EF and 3D-GLS, respectively. Individuals with poor IQ had lower 3D-EF and 3D-GLS (absolute) than those with good IQ (3D-EF: 52.8±6.0% versus 55.7±5.7%, Mean-Δ -2.9 [-3.9, 1.8]; 3D-GLS: 18.6±3.2% versus 19.2±2.9%, Mean-Δ -0.6 [-1.1, 0.0]). In 2 experimental models of poor IQ (n=36 for both), mean differences were (-2.6 to -3.2) for 3D-EF and (-1.2 to -2.0) for 3D-GLS. Similar findings were found for other 3DE left ventricle volumes and strain parameters. Conclusions 3DE parameters have low feasibility and values are systematically lower in individuals with poor IQ. Although 3D-EF and 3D-GLS have potential advantages over conventional echocardiography, further technical improvements are required to improve the utility of 3DE in clinical practice.

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Dataset Information

Midlife hypertensive status and cognitive function 20 years later: the Southall and Brent revisited study.

Objectives

Design

Setting

Participants

Measurements

Results

Conclusion

Publications

Midlife hypertensive status and cognitive function 20 years later: the Southall and Brent revisited study.

Similar Datasets

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