Nocturnal blood pressure in young adults and cognitive function in midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) study

Yuichiro Yano*, Hongyan Ning, Paul Muntner, Jared P. Reis, David A. Calhoun, Anthony J. Viera, Deborah A. Levine, David R. Jacobs, Daichi Shimbo, Kiang Liu, Philip Greenland, Donald Lloyd-Jones

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

BACKGROUND Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young Adults Study, including 224 participants (mean age 30 years, 45% men, 63% African Americans). At the 20-year follow-up, the Stroop test (executive function), Digit Symbol Substitution Test (psychomotor speed), and Rey Auditory Verbal Learning Test (verbal memory) were assessed. RESULTS Baseline mean office, daytime, and nocturnal BP were 109/73, 120/74, and 107/59mm Hg, respectively. Nocturnal BP dipping, calculated as (nocturnal systolic BP [SBP] - daytime SBP) × 100/daytime SBP, was divided into quartiles (Q1: -39.3% to -16.9%; Q2: -16.8% to -13.2%, Q3 [reference]: -13.1% to -7.8%, and Q4: -7.7% to +56.4%). In multiple regression analyses, the least nocturnal SBP dipping (Q4 vs. reference) and higher nocturnal diastolic BP level were associated with worse Stroop scores, with adjustments for demographic and clinical characteristics, and cumulative exposure to office BP during follow-up (β [standard error]: 0.37 [0.18] and 0.19 [0.07], respectively; all P < 0.05). Digit Symbol Substitution Test and Rey Auditory Verbal Learning Test were not significantly associated with nocturnal SBP dipping or nocturnal SBP/diastolic BP levels. CONCLUSIONS Among healthy young adults, less nocturnal SBP dipping and higher nocturnal diastolic BP levels were associated with lower executive function in midlife, independent of multiple measures of office BP during long-term follow-up.

Original languageEnglish (US)
Pages (from-to)1240-1247
Number of pages8
JournalAmerican Journal of Hypertension
Volume28
Issue number10
DOIs
StatePublished - Oct 2015

Keywords

  • blood pressure
  • cognitive function
  • hypertension
  • midlife
  • nocturnal blood pressure
  • young adults

ASJC Scopus subject areas

  • Internal Medicine

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