Evidence map›Paper›PMID 41109864›Full record

ArticleJournal of human hypertension2025

Late-life, visit-to-visit blood pressure variability and its association with sex-specific long-term cognitive outcomes.

Michael E Ernst, Kerry M Sheets, Katherine L Webb, Michelle A Fravel, Robyn L Woods, Lawrence Beilin, Suzanne G Orchard, Raj C Shah, Kevan R Polkinghorne, Christopher M Reid and 4 more

Abstract read
In one paragraph

Article in Journal of human hypertension, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Michael E ErnstDepartment of Pharmacy Practice and Science, College of Pharmacy; The University of Iowa, Iowa City, IA, USA. michael-ernst@uiowa.edu.ORCID http://orcid.org/0000-0003-0267-4888
Kerry M SheetsDepartment of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Katherine L WebbSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.ORCID http://orcid.org/0000-0002-9380-6075
Michelle A FravelDepartment of Pharmacy Practice and Science, College of Pharmacy; The University of Iowa, Iowa City, IA, USA.
Robyn L WoodsSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Lawrence BeilinMedical School Royal Perth Hospital, University of Western Australia, Perth, WA, Australia.ORCID http://orcid.org/0000-0003-4853-7360
Suzanne G OrchardSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Raj C ShahDepartment of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Ill, USA.ORCID http://orcid.org/0000-0001-9706-9730
Kevan R PolkinghorneSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Christopher M ReidSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Rory WolfeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Anne MurrayDepartment of Medicine, Hennepin Healthcare, Minneapolis, MN, USA.
Paul LacazeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Joanne RyanSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Funding

ASPirin in Reducing Events in the ElderlyU01AG029824 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI MCNEIL, JOHN JAMES, MURRAY, ANNE M · 2009 to 2018
$64.6M
Main Administrative CoreU19AG062682 · NIA · HENNEPIN HEALTHCARE RESEARCH INSTITUTE · PI CHAN, ANDREW T, MCNEIL, JOHN JAMES · 2019 to 2023
$42.9M
Department of Health | National Health and Medical Research Council (NHMRC) 1127060Department of Health | National Health and Medical Research Council (NHMRC) 334037NIA NIH HHS U01 AG029824NIA NIH HHS U19 AG062682U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging) U01AG029824U.S. Department of Health & Human Services | NIH | National Institute on Aging (U.S. National Institute on Aging) U19AG062682
6 · The paper itself

Abstract

In 19 114 community-dwelling older adults enrolled in the ASPREE trial, high late-life visit-to-visit blood pressure variability (BPV) was associated with increased risks of incident dementia and cognitive decline during the median 4.7 year trial period. Whether sex or apolipoprotein E (ApoE) affect these associations over longer-term follow-up is unknown. We investigated the association between BPV and long term risks of dementia and cognitive decline using data from the ASPREE-eXTension (ASPREE-XT) study (median 8.3 year follow-up for dementia, 7.3 years for cognitive decline, after BPV estimation). Long-term BPV was estimated using standard deviation (SD) of the mean systolic BPs measured at ASPREE baseline, year 1 and 2 visits. Incident dementia was an adjudicated secondary endpoint and cognitive decline was defined as ≥1.5 SD decline in score from baseline sustained on the same of one, or more, standardized cognitive tests administered annually/biennially throughout ASPREE/ASPREE-XT. Analyses were stratified a priori by sex, using sex-specific SD tertiles of systolic BPV. Multivariable Cox proportional hazards regression comparing the highest BPV tertile to the lowest showed increased risk of dementia (HR = 1.33, 1.10-1.61) and cognitive decline (HR = 1.17, 1.06-1.30) in males, and cognitive decline in females (HR = 1.17, 1.07-1.28). In ApoE genotyped participants (81%), females in the highest BPV tertile lacking the ɛ4 allele had increased risk of dementia (HR = 1.39; 1.04-1.84), while risk of cognitive decline was increased in both sexes lacking the ɛ4 allele (males HR = 1.25; 1.09-1.43; females HR = 1.14; 1.01-1.29). These findings suggest both sex and ApoE impact the association of high BPV with long-term cognitive changes.

Indexed as

Blood PressureCognitionCognitive DysfunctionDementiaHypertensionAgedAged, 80 and overAge FactorsApolipoproteins EFemaleHumansIncidenceMaleRisk FactorsSex FactorsTime FactorsApolipoproteins E

Identifiers

PMID41109864
PMCPMC12685738

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.