{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T16:43:53Z","timestamp":1770741833195,"version":"3.49.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"2022 Hubei Provincial Department of Science and Technology Innovation Program","award":["2023BCB029"],"award-info":[{"award-number":["2023BCB029"]}]},{"name":"Hubei Provincial Natural Science Foundation of China - Joint Fund","award":["JCZRLH202500401"],"award-info":[{"award-number":["JCZRLH202500401"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The impact of different fluctuation patterns of blood pressure (BP) on episodic memory remains underexplored, and the role of cumulative BP in this association remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using data from the China Health and Retirement Longitudinal Study, 6563 participants aged 45 years or more were analyzed. BP was measured in wave 1 (2011), wave 2 (2013), and wave 3 (2015). Cumulative systolic BP (SBP) during wave 1\u20133 (area under the curve) and the SBP difference between wave 1\u20132 and wave 2\u20133 were calculated. Then, SBP differences in the two intervals were used to identify patterns by K-means cluster analysis. Episodic memory, including immediate and delayed memory, was assessed in wave 4 (2018). Linear regression and mediation analysis were conducted, with multivariable adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Three fluctuation patterns of SBP were identified, characterized as an increase-decrease (19.9%), decrease-increase (25.7%), and stable (54.4%) pattern. Before cumulative SBP adjustment, compared to the stable SBP pattern, the \u03b2 (95% CIs) for episodic memory at wave 4 was \u22120.14 (\u22120.27, \u22120.01) for immediate memory, \u22120.12 (\u22120.31, 0.06) for delayed memory, and \u22120.27 (\u22120.57, 0.03) for total memory in the increase-decrease SBP pattern, and \u22120.06 (\u22120.18, 0.07), 0.01 (\u22120.15, 0.18), and \u22120.03 (\u22120.30, 0.25) in the decrease-increase SBP pattern. The overall association between the increase-decrease SBP pattern and immediate memory was partly mediated by cumulative SBP (29%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The increase-decrease pattern of SBP was associated with lower immediate memory three years later, and cumulative SBP partly mediated the association.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf161","type":"journal-article","created":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T11:32:05Z","timestamp":1756035125000},"page":"272-279","source":"Crossref","is-referenced-by-count":0,"title":["Associations of Blood Pressure Fluctuation Patterns With Cognitive Function: The Mediating Role of Cumulative Blood Pressure"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5220-1427","authenticated-orcid":false,"given":"Lixia","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Health Service and Management, School of Physical Education and Health, Hubei University of Chinese Medicine , Wuhan ,","place":["China"]},{"name":"Hubei Shizhen Laboratory , Wuhan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bingqing","family":"Lu","sequence":"additional","affiliation":[{"name":"Center for Evidence-Based Medicine, Hospital of Chengdu University of Traditional Chinese Medicine , Chengdu ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanzhuo","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Health Service and Management, School of Physical Education and Health, Hunan University of Technology and Business , Changsha ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanmei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hubei Shizhen Laboratory , Wuhan ,","place":["China"]},{"name":"Department of Preventive Medicine, School of Basic Medicine, Hubei University of Chinese Medicine , Wuhan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Health Service and Management, School of Physical Education and Health, Hubei University of Chinese Medicine , Wuhan ,","place":["China"]},{"name":"Hubei Shizhen Laboratory , Wuhan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuping","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Health Service and Management, School of Physical Education and Health, Hubei University of Chinese Medicine , Wuhan ,","place":["China"]},{"name":"Hubei Shizhen Laboratory , Wuhan ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,8,28]]},"reference":[{"key":"2026020915215540200_CIT0001","volume-title":"Dementia","author":"World Health Organization","year":"2023"},{"key":"2026020915215540200_CIT0002","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1186\/s13195-023-01211-y","article-title":"Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study","volume":"15","author":"Cho","year":"2023","journal-title":"Alzheimers Res Ther"},{"key":"2026020915215540200_CIT0003","doi-asserted-by":"crossref","first-page":"3435","DOI":"10.1002\/alz.12984","article-title":"Dementia occurring over a 32-year follow-up attributable to hypertension observed at different ages: implications for dementia prevention","volume":"19","author":"Smith","year":"2023","journal-title":"Alzheimers Dement"},{"key":"2026020915215540200_CIT0004","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/S0197-4580(00)00096-8","article-title":"Midlife blood pressure and dementia: the Honolulu-Asia aging study","volume":"21","author":"Launer","year":"2000","journal-title":"Neurobiol Aging"},{"key":"2026020915215540200_CIT0005","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1111\/j.1532-5415.2007.01233.x","article-title":"Age-varying association between blood pressure and risk of dementia in those aged 65 and older: a community-based prospective cohort study","volume":"55","author":"Li","year":"2007","journal-title":"J Am Geriatr Soc"},{"key":"2026020915215540200_CIT0006","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1161\/HYPERTENSIONAHA.118.12062","article-title":"Blood pressure and cognitive decline over 8 years in middle-aged and older Black and White Americans","volume":"73","author":"Levine","year":"2019","journal-title":"Hypertension"},{"key":"2026020915215540200_CIT0007","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s12920-020-00769-y","article-title":"Association of blood pressure with cognitive function at midlife: a Mendelian randomization study","volume":"13","author":"Sun","year":"2020","journal-title":"BMC Med Genomics"},{"key":"2026020915215540200_CIT0008","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/S1474-4422(19)30228-5","article-title":"Associations between blood pressure across adulthood and late-life brain structure and pathology in the neuroscience substudy of the 1946 British birth cohort (Insight 46): an epidemiological study","volume":"18","author":"Lane","year":"2019","journal-title":"Lancet Neurol"},{"key":"2026020915215540200_CIT0009","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000236913","article-title":"Low diastolic pressure and risk of dementia in very old people: a longitudinal study","volume":"28","author":"Qiu","year":"2009","journal-title":"Dement Geriatr Cogn Disord"},{"key":"2026020915215540200_CIT0010","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1161\/01.STR.0000133128.42462.ef","article-title":"Decline in blood pressure over time and risk of dementia: a longitudinal study from the Kungsholmen project","volume":"35","author":"Qiu","year":"2004","journal-title":"Stroke"},{"key":"2026020915215540200_CIT0011","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.jacc.2022.01.045","article-title":"Association of cumulative blood pressure with cognitive decline, dementia, and mortality","volume":"79","author":"Li","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026020915215540200_CIT0012","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1161\/CIRCULATIONAHA.119.042502","article-title":"Cumulative blood pressure exposure during young adulthood and mobility and cognitive function in midlife","volume":"141","author":"Mahinrad","year":"2020","journal-title":"Circulation"},{"key":"2026020915215540200_CIT0013","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.1097\/HJH.0000000000003808","article-title":"The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults","volume":"42","author":"Xu","year":"2024","journal-title":"J Hypertens"},{"key":"2026020915215540200_CIT0014","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1192\/bjp.2019.156","article-title":"Trajectory of blood pressure, body mass index, cholesterol and incident dementia: systematic review","volume":"216","author":"Peters","year":"2020","journal-title":"Br J Psychiatry"},{"key":"2026020915215540200_CIT0015","doi-asserted-by":"crossref","first-page":"931715","DOI":"10.3389\/fnagi.2022.931715","article-title":"Blood pressure trajectories over 35 years and dementia risk: a retrospective study: The HUNT study","volume":"14","author":"Selbaek","year":"2022","journal-title":"Front Aging Neurosci"},{"key":"2026020915215540200_CIT0016","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1161\/HYPERTENSIONAHA.111.182204","article-title":"Blood pressure trajectories from midlife to late life in relation to dementia in women followed for 37 years","volume":"59","author":"Joas","year":"2012","journal-title":"Hypertension"},{"key":"2026020915215540200_CIT0017","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1161\/HYPERTENSIONAHA.109.128744","article-title":"Change in blood pressure and incident dementia: a 32-year prospective study","volume":"54","author":"Stewart","year":"2009","journal-title":"Hypertension"},{"key":"2026020915215540200_CIT0018","doi-asserted-by":"crossref","first-page":"1084136","DOI":"10.3389\/fnagi.2023.1084136","article-title":"Associations between trajectories of cardiovascular risk factor change and cognitive impairment in Chinese elderly: a nationwide cohort study","volume":"15","author":"Duan","year":"2023","journal-title":"Front Aging Neurosci"},{"key":"2026020915215540200_CIT0019","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.14283\/jpad.2024.91","article-title":"Associations of blood pressure trajectories with subsequent cognitive decline, dementia and mortality","volume":"11","author":"Zhu","year":"2024","journal-title":"J Prev Alzheimers Dis"},{"key":"2026020915215540200_CIT0020","doi-asserted-by":"crossref","first-page":"17380","DOI":"10.18632\/aging.203228","article-title":"Trajectory patterns of blood pressure change up to six years and the risk of dementia: a nationwide cohort study","volume":"13","author":"Cheng","year":"2021","journal-title":"Aging (Albany NY)"},{"key":"2026020915215540200_CIT0021","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.ins.2022.11.139","article-title":"K-means clustering algorithms: a comprehensive review, variants analysis, and advances in the era of big data","volume":"622","author":"Ikotun","year":"2023","journal-title":"Inf Sci"},{"key":"2026020915215540200_CIT0022","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol"},{"key":"2026020915215540200_CIT0023","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1093\/rheumatology\/keu391","article-title":"Prevalence and risk factors of arthritis in a middle-aged and older Chinese population: the China health and retirement longitudinal study","volume":"54","author":"Li","year":"2015","journal-title":"Rheumatology (Oxford)"},{"key":"2026020915215540200_CIT0024","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2471\/BLT.13.124495","article-title":"Health system strengthening and hypertension awareness, treatment and control: data from the China Health and Retirement Longitudinal Study","volume":"92","author":"Feng","year":"2014","journal-title":"Bull World Health Organ"},{"key":"2026020915215540200_CIT0025","first-page":"603","article-title":"Chinese guidelines for the management of hypertension (2024 revised edition)","volume":"32","author":"Revision Committee of Chinese Guidelines for the Management of Hypertension, Chinese Hypertension League, Hypertension Branch of the Chinese Medical Care International Exchange Promotion Association, Hypertension Branch of Chinese Geriatrics Society, Hypertension Branch of Chinese Aging Well Association, Chinese Stroke Association, National Center for Chronic and Noncommunicable Disease Control and Prevention of the Chinese Center for Disease Control and Prevention","year":"2024","journal-title":"Chin J Hypertens"},{"key":"2026020915215540200_CIT0026","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1186\/s13195-024-01467-y","article-title":"Association between untreated and treated blood pressure levels and cognitive decline in community-dwelling middle-aged and older adults in China: a longitudinal study","volume":"16","author":"Li","year":"2024","journal-title":"Alzheimers Res Ther"},{"key":"2026020915215540200_CIT0027","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1016\/j.jagp.2022.03.005","article-title":"Associations between the prevalence, treatment, control of hypertension and cognitive trajectories among Chinese middle-aged and older adults","volume":"30","author":"Zhang","year":"2022","journal-title":"Am J Geriatr Psychiatry"},{"key":"2026020915215540200_CIT0028","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1002\/(SICI)1099-1166(199908)14:8<608::AID-GPS991>3.0.CO;2-Z","article-title":"Cross-validation of a short form of the CES-D in Chinese elderly","volume":"14","author":"Boey","year":"1999","journal-title":"Int J Geriatr Psychiatry"},{"key":"2026020915215540200_CIT0029","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00180-009-0178-4","article-title":"k-means for longitudinal data","volume":"25","author":"Genolini","year":"2010","journal-title":"Comput Stat"},{"key":"2026020915215540200_CIT0030","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s11556-023-00328-1","article-title":"Change in physical activity and systolic blood pressure trajectories throughout mid-life and the development of dementia in older age: the HUNT study","volume":"20","author":"Lerfald","year":"2023","journal-title":"Eur Rev Aging Phys Act"},{"key":"2026020915215540200_CIT0031","doi-asserted-by":"crossref","first-page":"glae161","DOI":"10.1093\/gerona\/glae161","article-title":"Longitudinal patterns of systolic blood pressure, diastolic blood pressure, cardiorespiratory fitness, and their association with dementia risk: the HUNT study","volume":"79","author":"Lerfald","year":"2024","journal-title":"J Gerontol A Biol Sci Med Sci"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/advance-article-pdf\/doi\/10.1093\/ajh\/hpaf161\/64169782\/hpaf161.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/39\/2\/272\/64169782\/hpaf161.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/39\/2\/272\/64169782\/hpaf161.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T20:22:09Z","timestamp":1770668529000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/39\/2\/272\/8244946"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,28]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,8,28]]},"published-print":{"date-parts":[[2026,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpaf161","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,8,28]]}}}