{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T03:12:28Z","timestamp":1782529948719,"version":"3.54.5"},"reference-count":42,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer\u2019s Disease"},{"name":"Johns Hopkins ADRC","award":["P30AG066507"],"award-info":[{"award-number":["P30AG066507"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elevated blood pressure (BP) is considered a risk factor for cognitive disorders. This study examined the continuous relationship between 2-year mean systolic BP (SBP) and incident cognitive disorders in a large, real-world primary care cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the associations of 2-year mean SBP with incident cognitive impairment in a \u2018real-world\u2019 clinical observational dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a longitudinal analysis of electronic health records (EHR) from primary care patients aged 50 or older. Patients were included if they had \u22652 SBP measurements and no cognitive disorder diagnosis prior to or within 3 years of their first included SBP measurement. Exposure was the average SBP in the two years following the first measurement. We estimated associations between (continuous) average SBP and incident cognitive impairment using a Cox model. Records from 160,052 patients were included in the analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In our study, SBP\u2009\u2265\u2009140\u2005mmHg is not associated with a statistically significant difference in cognitive disorder risk compared to lower SBP (&lt;120 and 120\u2013140\u2005mmHg). In the ages 60\u201369 group, SBP 135\u2005mmHg is the lowest SBP at which a significantly decreased risk for cognitive disorders was observed (HR, 0.84; 95% CI, 0.82\u20130.89; p\u2009&lt;\u20090.05). Among unmedicated individuals, 136\u2005mmHg SBP was the lowest SBP at which a statistically significant association with decreased cognitive disorder risk was observed (HR, 0.92; 95% CI, 0.87\u20131.00; p\u2009&lt;\u20090.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The association between SBP and cognitive disorder risk varies by age and BP medication use. This highlights the need for individualized BP targets to mitigate cognitive impairment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877251407126","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T18:55:13Z","timestamp":1766170513000},"page":"1428-1438","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of long-term systolic blood pressure on cognitive disorder risk: Across different age groups and antihypertensive medication timing"],"prefix":"10.1177","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7704-5368","authenticated-orcid":false,"given":"Konstantina","family":"Skolariki","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-4299","authenticated-orcid":false,"given":"Paul B.","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5080-6534","authenticated-orcid":false,"given":"Sevil","family":"Yasar","sequence":"additional","affiliation":[{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"},{"name":"Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9638-5763","authenticated-orcid":false,"given":"Esther S.","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"},{"name":"Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1010-1046","authenticated-orcid":false,"given":"Jeannie","family":"Leoutsakos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3827-4720","authenticated-orcid":false,"given":"Constantine G.","family":"Lyketsos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6859-3007","authenticated-orcid":false,"given":"Roy","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA"},{"name":"Richman Family Precision Medicine Center of Excellence in Alzheimer's Disease, Johns Hopkins University, Baltimore, MD, USA"},{"name":"Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01296-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-021-00430-6"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.123.21356"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000975"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.036140"},{"key":"e_1_3_3_7_2","first-page":"225","article-title":"Hypertension and cognitive dysfunction: a narrative review","volume":"40","author":"Cheon EJ","year":"2023","unstructured":"Cheon EJ. 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