{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T08:43:36Z","timestamp":1790671416108,"version":"4.1.0"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Blood pressure variability (BPV) in midlife increases risk of late\u2010life dementia, but the impact of BPV on the cognition of adults who have already reached older ages free of major cognitive deficits is unknown. We examined the risk of incident dementia and cognitive decline associated with long\u2010term, visit\u2010to\u2010visit BPV in a post hoc analysis of the ASPREE (Aspirin in Reducing Events in the Elderly) trial.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              ASPREE participants (N=19\u00a0114) were free of dementia and significant cognitive impairment at enrollment. Measurement of BP and administration of a standardized cognitive battery evaluating global cognition, delayed episodic memory, verbal fluency, and processing speed and attention occurred at baseline and follow\u2010up visits. Time\u2010to\u2010event analysis using Cox proportional hazards regression models were used to calculate hazard ratios (HR) and corresponding 95% CI for incident dementia and cognitive decline, according to tertile of SD of systolic BPV. Individuals in the highest BPV tertile compared with the lowest had an increased risk of incident dementia and cognitive decline, independent of average BP and use of antihypertensive drugs. There was evidence that sex modified the association with incident dementia (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.02), with increased risk in men (HR, 1.68; 95% CI, 1.19\u20132.39) but not women (HR, 1.01; 95% CI, 0.72\u20131.42). For cognitive decline, similar increased risks were observed for men and women (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.15; men: HR, 1.36; 95% CI, 1.16\u20131.59; women: HR, 1.14; 95% CI, 0.98\u20131.32).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">High BPV in older adults without major cognitive impairment, particularly men, is associated with increased risks of dementia and cognitive decline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01038583;\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.isrctn.com\">isrctn.com<\/jats:ext-link>\n              . Identifier: ISRCTN83772183.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019613","type":"journal-article","created":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T08:59:07Z","timestamp":1624697947000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":50,"title":["Long\u2010Term Blood Pressure Variability and Risk of Cognitive Decline and Dementia Among Older Adults"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0267-4888","authenticated-orcid":false,"given":"Michael E.","family":"Ernst","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice and Science College of Pharmacy The University of Iowa Iowa City IA"},{"name":"Department of Family Medicine Carver College of Medicine The University of Iowa Iowa City 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J.","family":"Beilin","sequence":"additional","affiliation":[{"name":"Medical School Royal Perth HospitalUniversity of Western Australia Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9173-3944","authenticated-orcid":false,"given":"Christopher M.","family":"Reid","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia"},{"name":"School of Public Health Curtin University Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9941-7161","authenticated-orcid":false,"given":"Mark R.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Menzies Institute for Medical Research University of Tasmania Hobart Tasmania 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