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The association between systolic blood pressure variability with depression, cognitive decline and white matter hyperintensities: the 3C Dijon MRI study

Published online by Cambridge University Press:  27 September 2017

P. J. Tully ,
S. Debette  and
C. Tzourio
P. J. Tully*
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, Australia
S. Debette
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France Department of Neurology, Bordeaux University Hospital, Bordeaux, France Department of Neurology, Framingham Heart Study, Boston University School of Medicine, Boston, MA, USA
C. Tzourio
Affiliation:
University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team HEALTHY, UMR1219, Bordeaux, France CHU de Bordeaux, Pole de sante publique, Service d'information medicale, Bordeaux, France
*
Author for correspondence: P. J. Tully, E-mail: phillip.tully@adelaide.edu.au
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Abstract

Background

Accumulating evidence links blood pressure variability (BPV) with white matter hyperintensities (WMH) and stroke. The longitudinal association between BPV with late onset depression (LOD) and cognitive decline remains unexplored.

Methods

Prospective cohort study of 2812 participant's age ⩾65 years (median age 72 years, 63.6% female) without dementia or stroke. Serial clinic visits assessed blood pressure, cognitive function, depression disorder, and depressive symptoms. A brain magnetic resonance imaging (MRI) substudy was performed in 1275 persons to examine possible associations with WMH.

Results

The interaction between symptomatic LOD and systolic BPV was associated with cognitive decline on the Isaac Set Test [slope −4.45; 95% confidence interval (CI) −8.92 to −0.16, p = 0.04], Benton Visual Retention Test (slope −0.89; 95% CI −1.77 to −0.01, p = 0.049), Mini Mental State Examination (slope −1.08; 95% CI −1.86 to −0.30, p = 0.007) and Finger Tapping Test (slope −7.53; 95% CI −13.71 to −1.34, p = 0.017) but not Trail Making Test-A or -B/A. The MRI substudy demonstrated that systolic BPV was associated with cognitive decline via interactions with depression and total WMH volume, but this was not dependent on either deep or periventricular WMH volumes.

Conclusions

The findings show that the interaction between systolic BPV with symptomatic depression and WMH increases cognitive decline in persons ⩾65 years of age. Future work could extend these findings by examining systolic BPV in relation to cognitive decline and WMH in older populations with depression.

Keywords

Blood pressureblood pressure variabilitydepressiongeriatric psychiatrymild cognitive impairmentwhite matter hyperintensity
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 9 , July 2018 , pp. 1444 - 1453
Copyright
Copyright © Cambridge University Press 2017 

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