| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Department of Gerontology (Drs. Zuccalà, Carosella, Bernabei, and Cocchi), Catholic University, Rome, Italy; Sticht Center on Aging (Drs. Onder and Pahor), Department of Internal Medicine, Wake Forest University, Winston Salem, NC; and Center for Gerontology and Health Care Research (Dr. Pedone), Brown University, Providence, RI.
Address correspondence and reprint requests to Dr. Giuseppe Zuccalà, Chair of Gerontology, Catholic University of the Sacred Heart, L.go F. Vito, 1-00168 Rome, Italy; e-mail: giuseppe_zuccala{at}rm.unicatt.it
Background:— Arterial hypotension has been associated with increased risk of dementia in some large prospective studies; and cognitive impairment is common among elderly with left ventricular function. The authors assessed whether arterial hypotension might be associated with cognitive impairment among older subjects with heart failure.
Methods:— This study involved all 13,635 patients (of whom 1,583 had heart failure) without cerebrovascular disease or AD, admitted to 81 Italian academic hospitals in 1995 and 1997. The association between blood pressure and cognitive impairment (as indicated by a Hodkinson Mental Test score < 7) according to the presence of heart failure was assessed by univariate analyses, including linear discriminant analysis. This association was also verified by multivariate analyses after stratifying for diagnosis of heart failure.
Results:— Cognitive impairment was found in 26% of patients with heart failure and in 19% of remaining subjects (Fisher exact p < 0.0001). Blood pressure levels did not differ according to diagnosis of heart failure, but discriminant analysis indicated that systolic blood pressure levels below 130 mm Hg predicted cognitive impairment only among participants with heart failure. Among such participants, systolic blood pressure was associated with cognitive impairment in multiple logistic regression modeling (for 10 mm Hg intervals, OR = 0.78; 95% CI = 0.71 to 0.86). Again, this association was not found among participants without heart failure.
Conclusions:— Systolic hypotension is selectively associated with cognitive impairment in older patients with heart failure. As early treatment of cardiac low-output states can reverse cognitive dysfunction, the routine management of heart failure should include systematic assessment of cognitive performance.
This article has been cited by other articles:
|
|
 |
|
  A. Bekker, M. Haile, Y.-S. Li, S. Galoyan, E. Garcia, D. Quartermain, A. Kamer, and T. Blanck Nimodipine Prevents Memory Impairment Caused by Nitroglycerin-Induced Hypotension in Adult Mice Anesth. Analg., December 1, 2009; 109(6): 1943 - 1948. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Pullicino, L. A. McClure, V. G. Wadley, A. Ahmed, V. J. Howard, G. Howard, and M. M. Safford Blood Pressure and Stroke in Heart Failure in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study Stroke, December 1, 2009; 40(12): 3706 - 3710. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Pierce, J. Pecen, and K. J. McLeod Influence of Seated Rocking on Blood Pressure in the Elderly: A Pilot Clinical Study Biol Res Nurs, October 1, 2009; 11(2): 144 - 151. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Singh-Manoux, S. Sabia, M. Lajnef, J. E. Ferrie, H. Nabi, A. R. Britton, M. G. Marmot, and M. J. Shipley History of coronary heart disease and cognitive performance in midlife: the Whitehall II study Eur. Heart J., September 1, 2008; 29(17): 2100 - 2107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L.C. Vogels, P. Scheltens, J. M. Schroeder-Tanka, and H. C. Weinstein Cognitive impairment in heart failure: A systematic review of the literature Eur J Heart Fail, May 1, 2007; 9(5): 440 - 449. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Farlow Use of Antidementia Agents in Vascular Dementia: Beyond Alzheimer Disease Mayo Clin. Proc., October 1, 2006; 81(10): 1350 - 1358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Qiu, B. Winblad, A. Marengoni, I. Klarin, J. Fastbom, and L. Fratiglioni Heart Failure and Risk of Dementia and Alzheimer Disease: A Population-Based Cohort Study. Arch Intern Med, May 8, 2006; 166(9): 1003 - 1008. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Altimir, J. Lupon, B. Gonzalez, M. Prats, T. Parajin, A. Urrutia, R. Coll, and V. Valle Sex and age differences in fragility in a heart failure population Eur J Heart Fail, August 1, 2005; 7(5): 798 - 802. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Verghese, R. B. Lipton, C. B. Hall, G. Kuslansky, and M. J. Katz Low blood pressure and the risk of dementia in very old individuals Neurology, December 23, 2003; 61(12): 1667 - 1672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Qiu, E. von Strauss, J. Fastbom, B. Winblad, and L. Fratiglioni Low Blood Pressure and Risk of Dementia in the Kungsholmen Project: A 6-Year Follow-up Study Arch Neurol, February 1, 2003; 60(2): 223 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Riegel, J. A. Bennett, A. Davis, B. Carlson, J. Montague, H. Robin, and D. Glaser Cognitive Impairment in Heart Failure: Issues of Measurement and Etiology Am. J. Crit. Care., November 1, 2002; 11(6): 520 - 528. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Freels, D. L. Nyenhuis, and P. B. Gorelick Predictors of survival in African American patients with AD, VaD, or stroke without dementia Neurology, October 22, 2002; 59(8): 1146 - 1153. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Sabatini, P. Barbisoni, R. Rozzini, M. Trabucchi, P. Pullicino, J. L. Halperin, and J. Hart Hypotension and cognitive impairment: Selective association in patients with heart failure Neurology, October 8, 2002; 59(7): 1118 - 1119. [Full Text] [PDF]
|
|
|
|
|
|
T. Sabatini, P. Barbisoni, R. Rozzini, M. Trabucchi, and G. Zuccala Hypotension and cognitive impairment: Selective association in patients with heart failure Neurology, August 27, 2002; 59(4): 651 - 651. [Full Text] [PDF]
|
|
|
|
 |
|
 Blood Pressure and Cognitive Impairment in Heart-Failure Patients Journal Watch Psychiatry, February 21, 2002; 2002(221): 10 - 10. [Full Text]
|
|
|
|
 |
|
 Blood Pressure and Cognitive Impairment in Heart Failure Patients Journal Watch (General), January 8, 2002; 2002(108): 1 - 1. [Full Text]
|
|
|
|
|
|
P. M. Pullicino and J. Hart Cognitive impairment in congestive heart failure?: Embolism vs hypoperfusion Neurology, December 11, 2001; 57(11): 1945 - 1946. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
