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Hypertension and cognition are minimally associated in late life


Hypertension impacts approximately 65% of persons over 60 years of age. Although previous studies have proposed an association between mid-life hypertension and late-life cognition, reports of associations between late-life hypertension and cognition have been mixed in the direction and magnitude of the observed associations and in the cognitive domains that may be affected. This study contrasted older adults with and without self-reported hypertension at two time points in late life (MBaseline age = 64.3 years, SD1 = 0.7; MFollow-up age = 71.2 years, SD2 = 0.9), separated by approximately seven years. Participants included 4314 1957 high school graduates from the Wisconsin Longitudinal Study who were followed longitudinally until 2011. Cognitive, demographic, and health variables from the 2003–2005 and 2011 data collection waves were used. Cognitive measures included letter and category fluency, digit ordering, similarities, and immediate and delayed recall. Bayesian independent t tests and regressions examined the association between self-reported hypertension status and cognition at baseline and follow-up. Persons with self-reported hypertension over seven years showed slightly worse letter fluency and digit ordering performance at follow-up than persons without self-reported hypertension. No baseline cognitive differences were observed between groups. Participants with self-reported hypertension showed no improvement in letter fluency or digit ordering compared to persons without self-reported hypertension. After controlling for cardiovascular risk factors, hypertension was associated only with a slight decline in letter fluency. Finally, hypertension duration was not associated with cognitive performance. Self-reported hypertension was associated with minimal to no effects on cognition in older adults. Controlling for cardiovascular risk factors eliminated virtually all associations between self-reported hypertension and cognition.

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This research used data from the Wisconsin Longitudinal Study, funded by the National Institute on Aging (R01 AG009775; R01 AG033285; R01 AG041868). Wisconsin Longitudinal Study (WLS) [graduates, siblings, and spouses]: 1957–2019 Version 13.07. [machine-readable data file]/Hauser, Robert M., William H. Sewell, and Pamela Herd. [principal investigator(s)]. Madison, WI: University of Wisconsin-Madison, WLS. [distributor]; We are grateful to the WLS Representatives and, in particular, to Professor Carol Roan, Study Director, who allowed us access to the data. We also gratefully acknowledge the assistance of Jessica Katschke, Kylie Kadey, and Bradley Dixon for their careful reading of this manuscript and editorial suggestions.

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Correspondence to John L. Woodard.

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Moll, A.C., Woodard, J.L. Hypertension and cognition are minimally associated in late life. Hypertens Res (2022).

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  • aging
  • cardiovascular
  • cognition
  • executive functioning
  • memory

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