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Abstract: TH-PO676

Baseline Diastolic Blood Pressure Does Not Influence the Effect of Systolic Blood Pressure Lowering on Cognition in Type 2 Diabetes Mellitus

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Gupta, Aditi, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Boucher, Robert E., University of Utah School of Medicine, Salt Lake City, Utah, United States
  • Greene, Tom, University of Utah, Salt Lake City, Utah, United States
  • Parks, Adam, University of Kansas Medical Center, Kansas City, Kansas, United States
  • Wei, Guo, University of Utah, Salt Lake City, Utah, United States
  • Beddhu, Srinivasan, University of Utah School of Medicine, Salt Lake City, Utah, United States
Background

In patients with low baseline diastolic blood pressure (DBP), lowering of systolic blood pressure (SBP) would lead to further lowering of mean arterial blood pressure. This can theoretically decrease cerebral perfusion and cognition. We examined the influence of baseline DBP on the effect of SBP on cognition.

Methods

We analyzed data from the Memory in Diabetes (MIND) sub-study of the Action to Control Cardiovascular Risk in Diabetes (ACCORD). We grouped the subjects by tertiles of baseline DBP and compared the effects of intensive (target <120 mm Hg) and standard (target <140 mm Hg) SBP control on cognition. Cognition was measured by Digit Symbol Substitution test (DSST), Rey Auditory Verbal Learning Test (RAVLT), Stroop test and the Mini Mental State exam (MMSE).

Results

Table 1 summarizes the baseline demographics of the 1,610 ACCORD-MIND participants divided by tertiles of DBP. Participates with lower DBP were older, and had a longer duration of diabetes. Figure 1 shows the DSST scores in the standard and intensive BP groups by baseline DBP tertiles. There was no difference in the change in DSST scores in the three groups.

Conclusion

Intensive SBP reduction in type 2 diabetes mellitus does not adversely affect cognition, even in those with low baseline DBP.

Funding

  • NIDDK Support