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Home blood pressure measurement consistency and cognitive impairment

Hypertension Research volume 47, pages 177–183 (2024)Cite this article

Abstract

Cognitive function tends to decline with age, and individuals with mild cognitive impairment (MCI) often have difficulty completing established self-management tasks. The aim of this study was to investigate the association between the number of days within a 5-and-a-half-day period that patients took their home blood pressure (BP) as instructed and MCI assessed by the Japanese version of the Montreal Cognitive Assessment (MoCA-J) in an elderly clinical population. We analyzed 303 ambulatory patients (mean age 77.3 ± 8.2 years) in whom MoCA-J had been assessed, who were instructed to take home BP for 1 evening and twice a day for the next five days, and who had at least one morning home BP measurement. After accounting for patient characteristics including age, sex, body mass index, drinking, smoking, prevalent cardiovascular disease, morning systolic BP and diastolic BP, and the use of antihypertensive drugs, the number of days home BP was measured was independently associated with both total MoCA-J score (estimate, 0.82; 95% confidence interval [CI], 0.43–1.21; P < 0.001) and the lowest quartile of MoCA-J score (13 or below) (odds ratio [OR], 0.72; 95%CI, 0.59–0.87; P = 0.001). Home BP measurement noncompliance (<5 days’ measurement) was also independently associated with the total MoCA-J score (estimate, −2.56; 95%CI, −4.09 to −1.03; P = 0.001) and the lowest quartile of MoCA-J score (OR, 3.32; 95%CI, 1.59–6.96; P = 0.001). In conclusion, poor compliance with home BP monitoring was associated with cognitive impairment in elderly cases who had been specifically instructed to perform home BP monitoring during a designated period.

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Acknowledgements

We particularly thank Nobuhiko Yasui and Shinobu Ozaki of A&D Co. for invaluable contributions to this project.

Funding

This work was supported by JSPS KAKENHI Grant Number JP22K10591.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan

    Satoshi Hoshide & Kazuomi Kario

  2. Department of Internal Medicine, Minamisanriku Hospital, Miyagi, Japan

    Masafumi Nishizawa

  3. Genki Plaza Medical Center for Health Care, Tokyo, Japan

    Hiroshi Kanegae

Authors
  1. Satoshi Hoshide
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  2. Masafumi Nishizawa
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  3. Hiroshi Kanegae
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  4. Kazuomi Kario
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Correspondence to Kazuomi Kario.

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KK has received research grants from Omron Healthcare and A&D Company. The other authors declare no competing interests.

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Hoshide, S., Nishizawa, M., Kanegae, H. et al. Home blood pressure measurement consistency and cognitive impairment. Hypertens Res 47, 177–183 (2024). https://doi.org/10.1038/s41440-023-01436-2

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