Evidence map›Paper›PMID 41655380›Full record

SynthesisThe journal of prevention of Alzheimer's disease2026

Cumulative blood pressure and risk of dementia and cognitive decline: a systematic review and meta-analysis.

Ruirui Wang, Yijie Gao, Nicole Ee, Fope Akinyede, Xiaoyue Xu, Linan Chen, Shangzhi Xiong, Xiaoying Chen, Craig S Anderson, Katie Harris and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The journal of prevention of Alzheimer's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

11 authors.

Ruirui WangDepartment of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Major Chronic Non-communicable Diseases, Suzhou Medical College of Soochow University, Suzhou 215123, China; The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia. Electronic address: rwang@georgeinstitute.org.au.
Yijie GaoThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia. Electronic address: z5206244@ad.unsw.edu.au.
Nicole EeThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Fope AkinyedeThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Xiaoyue XuThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia; School of Population Health, University of New South Wales, Sydney, NSW 2000, Australia.
Linan ChenThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Shangzhi XiongThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Xiaoying ChenThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Craig S AndersonThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia; Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai 200032, China; Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.
Katie HarrisThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.
Ruth PetersThe George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2000, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectiveCumulative blood pressure (cBP), reflecting long-term BP exposure, is increasingly used to examine risk associations with dementia and cognitive function, but findings to date are inconsistent. This systematic review aimed to synthesize existing evidence to clarify risk associations in adults.

methodsWe searched for articles in Medline, Embase (Ovid), Web of Science, Cochrane Library, and China National Knowledge Infrastructure from inception to January 2025 in any language. Longitudinal, observational studies involving participants aged over 18 years at the time of initial BP assessment were eligible for inclusion. cBP was defined as the area under the curve of BP values over time or an equivalent method, expressed in units of mmHg × time. Study outcomes were dementia, cognitive function assessments, and neuroimaging markers. This review is registered in PROSPERO (CRD42025640637).

resultsFrom 6334 records identified, 10 independent prospective cohort studies from 9 publications were included in the review, of which four cohort studies were eligible for meta-analysis. Meta-analysis showed that higher cumulative systolic BP (cSBP) was associated with an increased risk of incident dementia (odds ratio [OR] 1.21, 95% CI 1.00-1.45; I² = 92.4%, P for heterogeneity<0.001), while cumulative diastolic BP (cDBP) was not associated with dementia risk (OR 0.97, 95% CI 0.72-1.32; I²=97.3%, P for heterogeneity<0.001). Among eight studies on cognitive function, five reported that higher cSBP was associated with poorer cognitive performance, while three reported non-significant results. In contrast, findings for higher cDBP were mixed, with two studies reporting adverse associations, two reporting protective associations, and three reporting null associations. Two studies linked higher cSBP and cDBP to greater white matter hyperintensity burden. Sensitivity and subgroup analyses suggested that the positive association between cSBP and dementia-related outcomes were more pronounced among middle-aged adults, whereas inverse or null associations for higher cDBP was observed in some cohorts among individuals aged ≥60 years.

conclusionHigher cSBP is associated with increased risk of incident dementia and cognitive decline, whereas associations for cDBP are mixed. Given the limited evidence, future studies should incorporate age-stratified analyses and consider including cumulative pulse pressure and mean arterial pressure to further clarify the relationship between cBP and cognition.

Indexed as

Blood PressureCognitive DysfunctionDementiaHumansRisk FactorsCognitionCumulative blood pressureDementiaMeta analysisSystematic review

Identifiers

PMID41655380
PMCPMC12907844

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.