UNTREATED BLOOD-PRESSURE LEVEL IS INVERSELY RELATED TO COGNITIVE-FUNCTIONING - THE FRAMINGHAM-STUDY

It was hypothesized that blood pressure would be inversely related to cognitive functioning, if unconfounded with antihypertensive medicatio n and measured over many occasions prior to neuropsychological testing . For stroke-free Framingham Study participants aged 55-88 years (n = 1,702), blood pressure levels were averaged over five biennial examina tions (1956-1964) when few hypertensives were being treated, and exami ned in relation to neuropsychological tests administered between 1976 and 1978. With age, education, occupation, cigarette smoking, alcohol consumption, and gender controlled, blood pressure levels and chronici ty of hypertension were inversely related to the composite score and m easures of attention and memory. This was true for the full sample, fo r a subsample untreated during blood pressure measurement (n = 1,485), and for a subsample untreated throughout the entire study period (n = 1,038). For example, decline per 10 mmHg increment in blood pressure ranged from -0.04 to -0.07 standard score units (z) for the composite score. A negative finding previously was most likely due to blood pres sure measurement concurrently with neuropsychological testing, or too few measurements. Hypertension-associated pathogenic processes may cau se mild cognitive impairment, but other mechanisms need to be consider ed.