Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial
Abstract Background We aimed to explore the association between visit‐to‐visit systolic blood pressure variability (BPV) and cognitive function in individuals with type 2 diabetes. Methods We performed a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (A...
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| Format: | Article |
| Language: | English |
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Wiley
2024-10-01
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| Series: | Journal of Diabetes |
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| Online Access: | https://doi.org/10.1111/1753-0407.70020 |
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| author | Junmin Chen Xuan Zhao Huidan Liu Kan Wang Xiaoli Xu Siyu Wang Mian Li Ruizhi Zheng Libin Zhou Yufang Bi Yu Xu |
| author_facet | Junmin Chen Xuan Zhao Huidan Liu Kan Wang Xiaoli Xu Siyu Wang Mian Li Ruizhi Zheng Libin Zhou Yufang Bi Yu Xu |
| author_sort | Junmin Chen |
| collection | DOAJ |
| description | Abstract Background We aimed to explore the association between visit‐to‐visit systolic blood pressure variability (BPV) and cognitive function in individuals with type 2 diabetes. Methods We performed a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD‐MIND) substudy. A total of 2867 diabetes patients with ≥3 BP measurements between the 4‐ and 20‐month visits were included. Visit‐to‐visit systolic BPV was calculated. Cognitive decline was defined as a Mini‐Mental State Exam (MMSE), Digit Symbol Substitution Test (DSST), or Rey Auditory Verbal Learning Test (RAVLT) score greater than 1 standard deviation (SD) below the baseline mean, or a Stroop test score more than 1 SD above the baseline mean. The associations of systolic BPV with risks of cognitive decline were examined using Cox proportional hazards models, and with changes in brain magnetic resonance imaging parameters were evaluated using mixed models. Results The risk of cognitive decline defined by the DSST score (but not by other scores) increased significantly with systolic BPV quartiles (p for trend = 0.008), and there was a 55% increased risk for BPV quartile 4 versus quartile 1 (hazard ratio = 1.55, 95% confidence interval 1.10–2.19). Furthermore, a positive correlation was observed between systolic BPV and change in white matter lesion volume (β = 0.07, 95% CI 0.01–0.13). Conclusions A greater visit‐to‐visit systolic BPV was significantly associated with an increased risk of cognitive decline measured by DSST and an increase in white matter lesion volume in patients with type 2 diabetes. |
| format | Article |
| id | doaj-art-e0e483d436574e32adc0f0b62a2bd5d7 |
| institution | OA Journals |
| issn | 1753-0393 1753-0407 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes |
| spelling | doaj-art-e0e483d436574e32adc0f0b62a2bd5d72025-08-20T01:57:45ZengWileyJournal of Diabetes1753-03931753-04072024-10-011610n/an/a10.1111/1753-0407.70020Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trialJunmin Chen0Xuan Zhao1Huidan Liu2Kan Wang3Xiaoli Xu4Siyu Wang5Mian Li6Ruizhi Zheng7Libin Zhou8Yufang Bi9Yu Xu10School of Integrative Medicine Shanghai University of Traditional Chinese Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaSchool of Integrative Medicine Shanghai University of Traditional Chinese Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaSchool of Integrative Medicine Shanghai University of Traditional Chinese Medicine Shanghai ChinaDepartment of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital Shanghai Jiaotong University School of Medicine Shanghai ChinaAbstract Background We aimed to explore the association between visit‐to‐visit systolic blood pressure variability (BPV) and cognitive function in individuals with type 2 diabetes. Methods We performed a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD‐MIND) substudy. A total of 2867 diabetes patients with ≥3 BP measurements between the 4‐ and 20‐month visits were included. Visit‐to‐visit systolic BPV was calculated. Cognitive decline was defined as a Mini‐Mental State Exam (MMSE), Digit Symbol Substitution Test (DSST), or Rey Auditory Verbal Learning Test (RAVLT) score greater than 1 standard deviation (SD) below the baseline mean, or a Stroop test score more than 1 SD above the baseline mean. The associations of systolic BPV with risks of cognitive decline were examined using Cox proportional hazards models, and with changes in brain magnetic resonance imaging parameters were evaluated using mixed models. Results The risk of cognitive decline defined by the DSST score (but not by other scores) increased significantly with systolic BPV quartiles (p for trend = 0.008), and there was a 55% increased risk for BPV quartile 4 versus quartile 1 (hazard ratio = 1.55, 95% confidence interval 1.10–2.19). Furthermore, a positive correlation was observed between systolic BPV and change in white matter lesion volume (β = 0.07, 95% CI 0.01–0.13). Conclusions A greater visit‐to‐visit systolic BPV was significantly associated with an increased risk of cognitive decline measured by DSST and an increase in white matter lesion volume in patients with type 2 diabetes.https://doi.org/10.1111/1753-0407.70020blood pressure variabilitycognitive functiontype 2 diabetes |
| spellingShingle | Junmin Chen Xuan Zhao Huidan Liu Kan Wang Xiaoli Xu Siyu Wang Mian Li Ruizhi Zheng Libin Zhou Yufang Bi Yu Xu Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial Journal of Diabetes blood pressure variability cognitive function type 2 diabetes |
| title | Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial |
| title_full | Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial |
| title_fullStr | Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial |
| title_full_unstemmed | Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial |
| title_short | Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial |
| title_sort | association of systolic blood pressure variability with cognitive decline in type 2 diabetes a post hoc analysis of a randomized clinical trial |
| topic | blood pressure variability cognitive function type 2 diabetes |
| url | https://doi.org/10.1111/1753-0407.70020 |
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