Blood pressure, hypertension, and age as risk factors for poor cognitive performance.

The relationships of three blood pressure variables (systolic and diastolic pressures and chronicity of hypertension) and age to cognitive performance on the Kaplan-Albert Neuropsychological Test Battery were explored in a sample of 1,695 stroke-free participants of the Framingham Heart Study. Multiple blood pressure measurements were obtained over four or five exams extending over 8-10 years. Neuropsychological testing was conducted 12-14 years after the final blood pressure measurement. Data were subject to multiple binary logistic regression analyses, and odds ratios were calculated for performance in the lower 50th and 25th percentiles for 10-mmHg increases in diastolic blood pressure, 20-mmHg increases in systolic blood pressure, proportion of exams (out of four or five) in which participants were diagnosed as hypertensive, and 10-year increases in age. Blood pressures and chronicity of hypertension were inversely associated with performance on visual and verbal memory tests of the Kaplan-Albert battery. Age was inversely associated with performance on all tests in the battery. Generally, the odds of performing poorly were higher for age than for the blood pressure variables. The epidemiological significance of these findings is discussed in terms of implications for public health and management of hypertension.