Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation
Atrial fibrillation (AF) is associated with increased risk of cognitive impairment and dementia, even with no overt stroke. Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife (
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| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 2020-05, Vol.75 (5), p.1296-1304 |
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| creator | Kim, Daehoon Yang, Pil-Sung Jang, Eunsun Tae Yu, Hee Kim, Tae-Hoon Uhm, Jae-Sun Kim, Jong-Youn Sung, Jung-Hoon Pak, Hui-Nam Lee, Moon-Hyoung Lip, Gregory Y.H. Joung, Boyoung |
| description | Atrial fibrillation (AF) is associated with increased risk of cognitive impairment and dementia, even with no overt stroke. Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife ( |
| doi_str_mv | 10.1161/HYPERTENSIONAHA.119.14388 |
| format | Article |
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Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife (<70 years) individuals. We aimed to investigate the associations of blood pressure (BP) and hypertension burden with dementia risk among midlife AF patients. From the Korean National Health Insurance Service database, we enrolled 171 228 incident AF patients aged 50 to 69 years with no prior dementia from 2005 to 2016. During a mean of 6.6 years of follow-up, 9909 patients received a first-time diagnosis of dementia. U-shaped relationships were noted between systolic or diastolic BP and dementia riskA 10 mm Hg increase or decrease in systolic BP starting from 120 mm Hg was associated with 4.4% (95% CI, 2.7%–6.0%) and 4.6% (95% CI, 0.1%–8.2%) higher dementia risk, respectively. An increase or decrease in diastolic BP starting from 80 mm Hg also increased dementia risk. In subtype analyses, Alzheimer disease increases with BP decrease whereas vascular dementia increases according to BP increase. When BP changes over time were accounted for in time-updated models, BP of 120 to 129/80 to 84 mm Hg was associated with the lowest dementia risk. Increasing hypertension burden (the proportion of days with increased BP during follow-up) was associated with higher dementia risk (hazard ratio, 1.10 per 10% increase [95% CI, 1.08–1.12]). Among midlife AF patients, there were a U-shaped association of BP and a log-linear association of hypertension burden with dementia risk. Minimizing the burden of hypertension in AF patients might help to prevent dementia.</description><identifier>ISSN: 0194-911X</identifier><identifier>EISSN: 1524-4563</identifier><identifier>DOI: 10.1161/HYPERTENSIONAHA.119.14388</identifier><identifier>PMID: 32172620</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Age of Onset ; Aged ; Atrial Fibrillation - epidemiology ; Atrial Fibrillation - etiology ; Atrial Fibrillation - psychology ; Blood Pressure - drug effects ; Cardiovascular Diseases - epidemiology ; Causality ; Comorbidity ; Dementia - epidemiology ; Dementia - etiology ; Dementia - prevention & control ; Dementia, Vascular - epidemiology ; Dementia, Vascular - etiology ; Dementia, Vascular - prevention & control ; Diabetes Mellitus - epidemiology ; Dyslipidemias - epidemiology ; Female ; Humans ; Hypertension - complications ; Hypertension - epidemiology ; Hypertension - physiopathology ; Hypertension - psychology ; Liver Diseases - epidemiology ; Male ; Middle Aged ; Neoplasms - epidemiology ; Proportional Hazards Models ; Renal Insufficiency, Chronic - epidemiology ; Republic of Korea - epidemiology ; Risk</subject><ispartof>Hypertension (Dallas, Tex. 1979), 2020-05, Vol.75 (5), p.1296-1304</ispartof><rights>American Heart Association, Inc</rights><rights>2020 American Heart Association, Inc</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4678-3d3515bf26ef3cf4f82232c3af6c0a2a17eedda3ec80cbf4232805079d6501f43</citedby><cites>FETCH-LOGICAL-c4678-3d3515bf26ef3cf4f82232c3af6c0a2a17eedda3ec80cbf4232805079d6501f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32172620$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Daehoon</creatorcontrib><creatorcontrib>Yang, Pil-Sung</creatorcontrib><creatorcontrib>Jang, Eunsun</creatorcontrib><creatorcontrib>Tae Yu, Hee</creatorcontrib><creatorcontrib>Kim, Tae-Hoon</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Kim, Jong-Youn</creatorcontrib><creatorcontrib>Sung, Jung-Hoon</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Lip, Gregory Y.H.</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><title>Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation</title><title>Hypertension (Dallas, Tex. 1979)</title><addtitle>Hypertension</addtitle><description>Atrial fibrillation (AF) is associated with increased risk of cognitive impairment and dementia, even with no overt stroke. Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife (<70 years) individuals. We aimed to investigate the associations of blood pressure (BP) and hypertension burden with dementia risk among midlife AF patients. From the Korean National Health Insurance Service database, we enrolled 171 228 incident AF patients aged 50 to 69 years with no prior dementia from 2005 to 2016. During a mean of 6.6 years of follow-up, 9909 patients received a first-time diagnosis of dementia. U-shaped relationships were noted between systolic or diastolic BP and dementia riskA 10 mm Hg increase or decrease in systolic BP starting from 120 mm Hg was associated with 4.4% (95% CI, 2.7%–6.0%) and 4.6% (95% CI, 0.1%–8.2%) higher dementia risk, respectively. An increase or decrease in diastolic BP starting from 80 mm Hg also increased dementia risk. In subtype analyses, Alzheimer disease increases with BP decrease whereas vascular dementia increases according to BP increase. When BP changes over time were accounted for in time-updated models, BP of 120 to 129/80 to 84 mm Hg was associated with the lowest dementia risk. Increasing hypertension burden (the proportion of days with increased BP during follow-up) was associated with higher dementia risk (hazard ratio, 1.10 per 10% increase [95% CI, 1.08–1.12]). Among midlife AF patients, there were a U-shaped association of BP and a log-linear association of hypertension burden with dementia risk. Minimizing the burden of hypertension in AF patients might help to prevent dementia.</description><subject>Age of Onset</subject><subject>Aged</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Atrial Fibrillation - etiology</subject><subject>Atrial Fibrillation - psychology</subject><subject>Blood Pressure - drug effects</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Causality</subject><subject>Comorbidity</subject><subject>Dementia - epidemiology</subject><subject>Dementia - etiology</subject><subject>Dementia - prevention & control</subject><subject>Dementia, Vascular - epidemiology</subject><subject>Dementia, Vascular - etiology</subject><subject>Dementia, Vascular - prevention & control</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Dyslipidemias - epidemiology</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension - physiopathology</subject><subject>Hypertension - psychology</subject><subject>Liver Diseases - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms - epidemiology</subject><subject>Proportional Hazards Models</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Republic of Korea - epidemiology</subject><subject>Risk</subject><issn>0194-911X</issn><issn>1524-4563</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE9PGzEQxa2KqqShXwG5Ny4L4z_r3T30ENLQIKUQURBwWjm7Y8XgrMHeFeq3x22AQw8VlixL896bGf8I-crgkDHFjua3y9nF5ezs1-n52WQ-ScXqkElRlh_IiOVcZjJXYoeMgFUyqxi72SWfY7wDYFLK4hPZFZwVXHEYkatj531LlwFjHALSqe_64B3VXUu_4wa73mp6YeM9tR39aVtnDdKl7m1SIr22_ZpO-mC1oyd2FaxzSfLdHvlotIv45eUdk6uT2eV0ni3Of5xOJ4uskaooM9GKnOUrwxUa0RhpSs4Fb4Q2qgHNNSsQ21YLbEpoVkYmsYQciqpVOTAjxZgcbPs-BP84YOzrjY0Npi069EOsuSgKVUoBkKzV1toEH2NAUz8Eu9Hhd82g_kO1_odqKlb1X6opu_8yZlhtsH1LvmJMhm9bw5N3PYZ474YnDPUatevX7xog_5OHdCRXZcaBQ_o_QJZuQvUMhHmYRQ</recordid><startdate>20200501</startdate><enddate>20200501</enddate><creator>Kim, Daehoon</creator><creator>Yang, Pil-Sung</creator><creator>Jang, Eunsun</creator><creator>Tae Yu, Hee</creator><creator>Kim, Tae-Hoon</creator><creator>Uhm, Jae-Sun</creator><creator>Kim, Jong-Youn</creator><creator>Sung, Jung-Hoon</creator><creator>Pak, Hui-Nam</creator><creator>Lee, Moon-Hyoung</creator><creator>Lip, Gregory Y.H.</creator><creator>Joung, Boyoung</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20200501</creationdate><title>Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation</title><author>Kim, Daehoon ; Yang, Pil-Sung ; Jang, Eunsun ; Tae Yu, Hee ; Kim, Tae-Hoon ; Uhm, Jae-Sun ; Kim, Jong-Youn ; Sung, Jung-Hoon ; Pak, Hui-Nam ; Lee, Moon-Hyoung ; Lip, Gregory Y.H. ; Joung, Boyoung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4678-3d3515bf26ef3cf4f82232c3af6c0a2a17eedda3ec80cbf4232805079d6501f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age of Onset</topic><topic>Aged</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Atrial Fibrillation - etiology</topic><topic>Atrial Fibrillation - psychology</topic><topic>Blood Pressure - drug effects</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Causality</topic><topic>Comorbidity</topic><topic>Dementia - epidemiology</topic><topic>Dementia - etiology</topic><topic>Dementia - prevention & control</topic><topic>Dementia, Vascular - epidemiology</topic><topic>Dementia, Vascular - etiology</topic><topic>Dementia, Vascular - prevention & control</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Dyslipidemias - epidemiology</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension - physiopathology</topic><topic>Hypertension - psychology</topic><topic>Liver Diseases - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms - epidemiology</topic><topic>Proportional Hazards Models</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Republic of Korea - epidemiology</topic><topic>Risk</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Daehoon</creatorcontrib><creatorcontrib>Yang, Pil-Sung</creatorcontrib><creatorcontrib>Jang, Eunsun</creatorcontrib><creatorcontrib>Tae Yu, Hee</creatorcontrib><creatorcontrib>Kim, Tae-Hoon</creatorcontrib><creatorcontrib>Uhm, Jae-Sun</creatorcontrib><creatorcontrib>Kim, Jong-Youn</creatorcontrib><creatorcontrib>Sung, Jung-Hoon</creatorcontrib><creatorcontrib>Pak, Hui-Nam</creatorcontrib><creatorcontrib>Lee, Moon-Hyoung</creatorcontrib><creatorcontrib>Lip, Gregory Y.H.</creatorcontrib><creatorcontrib>Joung, Boyoung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Daehoon</au><au>Yang, Pil-Sung</au><au>Jang, Eunsun</au><au>Tae Yu, Hee</au><au>Kim, Tae-Hoon</au><au>Uhm, Jae-Sun</au><au>Kim, Jong-Youn</au><au>Sung, Jung-Hoon</au><au>Pak, Hui-Nam</au><au>Lee, Moon-Hyoung</au><au>Lip, Gregory Y.H.</au><au>Joung, Boyoung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation</atitle><jtitle>Hypertension (Dallas, Tex. 1979)</jtitle><addtitle>Hypertension</addtitle><date>2020-05-01</date><risdate>2020</risdate><volume>75</volume><issue>5</issue><spage>1296</spage><epage>1304</epage><pages>1296-1304</pages><issn>0194-911X</issn><eissn>1524-4563</eissn><abstract>Atrial fibrillation (AF) is associated with increased risk of cognitive impairment and dementia, even with no overt stroke. Hypertension has been a potentially modifiable risk factor for dementia, especially in midlife (<70 years) individuals. We aimed to investigate the associations of blood pressure (BP) and hypertension burden with dementia risk among midlife AF patients. From the Korean National Health Insurance Service database, we enrolled 171 228 incident AF patients aged 50 to 69 years with no prior dementia from 2005 to 2016. During a mean of 6.6 years of follow-up, 9909 patients received a first-time diagnosis of dementia. U-shaped relationships were noted between systolic or diastolic BP and dementia riskA 10 mm Hg increase or decrease in systolic BP starting from 120 mm Hg was associated with 4.4% (95% CI, 2.7%–6.0%) and 4.6% (95% CI, 0.1%–8.2%) higher dementia risk, respectively. An increase or decrease in diastolic BP starting from 80 mm Hg also increased dementia risk. In subtype analyses, Alzheimer disease increases with BP decrease whereas vascular dementia increases according to BP increase. When BP changes over time were accounted for in time-updated models, BP of 120 to 129/80 to 84 mm Hg was associated with the lowest dementia risk. Increasing hypertension burden (the proportion of days with increased BP during follow-up) was associated with higher dementia risk (hazard ratio, 1.10 per 10% increase [95% CI, 1.08–1.12]). Among midlife AF patients, there were a U-shaped association of BP and a log-linear association of hypertension burden with dementia risk. Minimizing the burden of hypertension in AF patients might help to prevent dementia.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>32172620</pmid><doi>10.1161/HYPERTENSIONAHA.119.14388</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age of Onset Aged Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Atrial Fibrillation - psychology Blood Pressure - drug effects Cardiovascular Diseases - epidemiology Causality Comorbidity Dementia - epidemiology Dementia - etiology Dementia - prevention & control Dementia, Vascular - epidemiology Dementia, Vascular - etiology Dementia, Vascular - prevention & control Diabetes Mellitus - epidemiology Dyslipidemias - epidemiology Female Humans Hypertension - complications Hypertension - epidemiology Hypertension - physiopathology Hypertension - psychology Liver Diseases - epidemiology Male Middle Aged Neoplasms - epidemiology Proportional Hazards Models Renal Insufficiency, Chronic - epidemiology Republic of Korea - epidemiology Risk |
| title | Blood Pressure Control and Dementia Risk in Midlife Patients With Atrial Fibrillation |
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