Cumulative BP exposure in young adulthood linked to gait, cognitive performance in midlife

Individuals exposed to elevated blood pressure (BP) levels from young adulthood to midlife are likely to have poor gait and cognitive performance in midlife, a study suggests. Cerebral white matter hyperintensity (WMH) moderates the relationship of cumulative BP exposure with gait but not with cognitive function.

The study involved 191 participants from a community-based cohort of young individuals followed for >30 years. Researchers calculated cumulative BP as the area under the curve (mm Hg multiplied by years) from baseline up to year 30, as well as assessed gait and cognition at the year 30 follow up. A subset of 144 participants who underwent magnetic resonance imaging had available cerebral WMH data.

Multiple linear regression models revealed that higher cumulative systolic and diastolic BP were associated with the following gait parameters at the 30-year follow-up: slower walking speed (p-both=0.010), smaller step length (p=0.011 and p=0.005, respectively) and higher gait variability (p=0.018 and p=0.001, respectively).

With respect to cognition, higher cumulative systolic BP correlated with lower cognitive performance in the executive (p=0.021), memory (p=0.015) and global domains (p=0.010). Meanwhile, higher cumulative diastolic BP was linked to lower cognitive performance in the memory domain (p=0.012). All associations were controlled for sociodemographics and vascular risk factors (eg, body mass index, smoking, diabetes and total cholesterol).

Interestingly, WMH burden moderated the association between cumulative BP and gait (p-interaction<0.05) but not between cumulative BP and cognitive function (p-interaction>0.05).

In light of the findings, the researchers called for additional longitudinal studies to investigate the mechanisms underpinning the impact of BP exposure on brain structure and function using a life course approach.