Blood Pressure and Hispanic/Latino Cognitive Function: Hispanic Community Health Study/Study of Latinos Results

Article type: Research Article

Authors: Tarraf, Wassim^a | Rodríguez, Carlos J.^b | Daviglus, Martha L.^c | Lamar, Melissa^{c; d} | Schneiderman, Neil^e | Gallo, Linda^f | Talavera, Gregory A.^f | Kaplan, Robert C.^g | Fornage, Myriam^h | Conceicao, Alanⁱ | González, Hector M.^{i; *}

Affiliations: [a] Department of Healthcare Sciences and Wayne State University, Institute of Gerontology, Detroit, MI, USA | [b] Department of Medicine and Department of Epidemiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA | [c] University of Illinois at Chicago, Institute for Minority Health Research, College of Medicine at Chicago, Chicago, IL, USA | [d] Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA | [e] Department of Psychology, University of Miami, Coral Gables, FL, USA | [f] San Diego State University, Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego, CA, USA | [g] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA | [h] University of Texas Health Science Center, Institute of Molecular Medicine and Human Genetics Center, San Antonio, TX, USA | [i] Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA

Correspondence: [*] Correspondence to: Hector M. González, Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Fee Rd, East Lansing, MI 48824, USA. Tel.: +1 517 884 6628; E-mail: [email protected].

Abstract: Background: Hispanics/Latinos are at increased risk for cardiovascular disease and cognitive decline and dementias. High blood pressure (BP) has been implicated in both stroke and dementias. Associations between BP and cognition among diverse Latinos are still unpublished. Objective: We examined associations between cognition and four BP based measures among diverse Hispanics/Latinos. We hypothesized that higher BP, particularly systolic pressure, and increased arterial stiffness (i.e., pulse pressure), would be associated with lower cognitive function. Methods: We used baseline (2008–2011) Hispanic Community Health Study/Study of Latinos (HCHS/SOL; n = 9,019; ages 45–74 years) data to examine cognition in relation to BP measures. Results: In age, sex, and education adjusted models, systolic, pulse, and mean arterial pressure were consistently negatively associated with executive function, psychomotor speed and sustained attention, verbal episodic learning and memory, speech fluency, and mental status measures. These associations were attenuated but remained statistically significant in fully adjusted models. Conclusion: Among middle-aged and older diverse Hispanics/Latinos, we found modest but consistent associations between indicators of arterial stiffness, and compromised blood flow and lower cognitive function. Clinical management and public health interventions to raise awareness and enhance BP management beginning in midlife could reduce disparities and improve population health by reducing cognitive decline burdens.

Keywords: Arterial stiffness, bloodpressure, cardiovascular health, cognitive, Hispanic/Latino, hypertension, neurocognitive

DOI: 10.3233/JAD-170017

Journal: Journal of Alzheimer's Disease, vol. 59, no. 1, pp. 31-42, 2017