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Abstract: TH-OR45

Baseline and Time-Updated Systolic Blood Pressure and Incident Cognitive Impairment in the Chronic Renal Insufficiency Cohort

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Babroudi, Seda, Tufts Medical Center, Boston, Massachusetts, United States
  • Tighiouart, Hocine, Tufts Medical Center, Boston, Massachusetts, United States
  • Schrauben, Sarah J., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Cohen, Jordana B., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • He, Jiang, Tulane University School of Medicine, New Orleans, Louisiana, United States
  • Rao, Panduranga S., University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
  • Fischer, Michael J., University of Illinois Hospital and Health Sciences System, Chicago, Illinois, United States
  • Rahman, Mahboob, University Hospitals, Cleveland, Ohio, United States
  • Go, Alan S., Kaiser Permanente Northern California, Oakland, California, United States
  • Hsu, Chi-yuan, UCSF Medical Center, San Francisco, California, United States
  • Sozio, Stephen M., Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Weir, Matthew R., University of Maryland Medical System, Baltimore, Maryland, United States
  • Sarnak, Mark J., Tufts Medical Center, Boston, Massachusetts, United States
  • Yaffe, Kristine, UCSF Medical Center, San Francisco, California, United States
  • Kurella Tamura, Manjula, Stanford University School of Medicine, Stanford, California, United States
  • Drew, David A., Tufts Medical Center, Boston, Massachusetts, United States
Background

A linear relationship exists between systolic blood pressure (SBP) and cognitive impairment in the general population. Patients with chronic kidney disease (CKD) are at higher risk for hypertension and cognitive impairment. We therefore sought to investigate the relationship between SBP and cognitive impairment in patients with CKD.

Methods

Using data from the Chronic Renal Insufficiency Cohort Study, we investigated the association between baseline and time-updated SBP and incident cognitive impairment, defined as a mini-mental state (3MS) score < 80, during annual assessments using discrete hazards models that adjusted for demographics as well as cardiovascular and kidney disease risk factors.

Results

Mean (SD) age and eGFR (SD) by the CKD-Epi equation of the 3753 participants were 58 years (11), and 44 mL/min/1.73m2 (15), respectively. Baseline cognitive impairment was present in 10.1% of overall participants (n = 365), and 5.4%, 9.5%, and 16.4% of participants with baseline SBP <120, 120-140, and ≥140 mm Hg, respectively (p < 0.01). There were 314 individuals who developed cognitive impairment during a median 6 years of follow-up. After multivariable adjustment, participants with higher baseline SBP were more likely to have incident cognitive impairment (hazard ratio (HR) [95%CI] = 1.09 [1.03, 1.16] per 10 mmHg higher SBP); this relationship was attenuated when using time-updated SBP (HR [95%CI] = 1.04 [0.99, 1.10]) (Table 1).

Conclusion

Among patients with CKD, elevated baseline SBP but not time-updated SBP was associated with incident cognitive impairment.

Funding

  • NIDDK Support