Midlife Hypertension May Speed Cognitive Decline

(HealthDay News) — Hypertension during midlife is associated with greater cognitive decline during a 20-year period, according to research published online in JAMA Neurology.

Rebecca F. Gottesman, MD, PhD, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues assessed the association between midlife (age 48 to 67 years) hypertension and the 20-year change in cognitive performance among 13,476 participants (African-American and white).

Among the 58% of living participants who completed the 20-year cognitive follow-up, baseline hypertension, compared with normal blood pressure (BP), was associated with a significant additional cognitive decline of 0.056 global z score points (95% CI, −0.100 to −0.012). 

Prehypertension was associated with a nonsignificant additional cognitive decline of 0.040 global z score points (95% CI, −0.085 to 0.005). 

Participants with hypertension who received antihypertensive agents had less cognitive decline during the study period than untreated participants with hypertension (−0.050; 95% CI, −0.003 to −0.097 vs. −0.079; 95% CI, −0.156 to −0.002 global z score points). 

In continuous systolic BP analyses, each 20-mm Hg increment at baseline was associated with an additional cognitive decline of 0.048 (95% CI, −0.074 to −0.022) global z score points in whites and 0.020 (95% CI, −0.026 to 0.066) global z score points in African-Americans.

“The study provides a unique opportunity to understand the role of raised BP on cognition during a 20-year period,” wrote the author of an accompanying editorial.

One study author and the editorial author disclosed financial ties to pharmaceutical companies.


  1. Gottesman RF et al. JAMA Neurol. 2014;doi:10.1001/jamaneurol.2014.1646.
  2. Gorelick PB. JAMA Neurol. 2014;doi:10.1001/jamaneurol.2014.2014.