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62/100

✓ Peer-reviewed alzhub usefulness score 62 out of 100. Disparities

Topic: Risk, prevention and care in population studies

Although the association between high blood pressure (BP), particularly in midlife, and late-life dementia is known, less is known about variations by race and sex. In a prospective national study of 22 164 blacks and whites ≥45 years without baseline cognitive impairment or stroke from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke), enrolled 2003 to 2007 and followed through September 2015, we measured changes in cognition associated with baseline systolic and diastolic BP (SBP and DBP), as well as pulse pressure (PP) and mean arterial pressure, and we tested whether age, race, and sex modified the effects. Outcomes were global cognition (Six-Item Screener; primary outcome), new learning (Word List Learning), verbal memory (Word List Delayed Recall), and executive function (Animal Fluency Test). Median follow-up was 8.1 years. Significantly faster declines in global cognition were associated with higher SBP, lower DBP, and higher PP with increasing age ( P<0.001 for age×SBP×follow-up-time, age×DBP×follow-up-time, and age×PP×follow-up-time interaction). Declines in global cognition were not associated with mean arterial pressure after adjusting for PP. Blacks, compared with whites, had faster declines in global cognition associated with SBP ( P=0.02) and mean arterial pressure ( P=0.04). Men, compared with women, had faster declines in new learning associated with SBP ( P=0.04). BP was not associated with decline of verbal memory and executive function, after controlling for the effect of age on cognitive trajectories. Significantly faster declines in global cognition over 8 years were associated with higher SBP, lower DBP, and higher PP with increasing age. SBP-related cognitive declines were greater in blacks and men.

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APA 7th

Levine, D. A., Galecki, A. T., Langa, K. M., Unverzagt, F. W., Kabeto, M. U., Giordani, B., et al. (2019). Blood Pressure and Cognitive Decline Over 8 Years in Middle-Aged and Older Black and White Americans. Hypertension (Dallas, Tex. : 1979). https://doi.org/10.1161/hypertensionaha.118.12062

Vancouver

Levine DA, Galecki AT, Langa KM, Unverzagt FW, Kabeto MU, Giordani B, et al. Blood Pressure and Cognitive Decline Over 8 Years in Middle-Aged and Older Black and White Americans. Hypertension (Dallas, Tex. : 1979). 2019. doi:10.1161/hypertensionaha.118.12062. PMID: 30624986.

BibTeX

@article{levine2019-30624986,
  author  = {Levine, D. A. and Galecki, A. T. and Langa, K. M. and Unverzagt, F. W. and Kabeto, M. U. and Giordani, B. and Cushman, M. and McClure, L. A. and others},
  title   = {{Blood Pressure and Cognitive Decline Over 8 Years in Middle-Aged and Older Black and White Americans}},
  journal = {Hypertension (Dallas, Tex. : 1979)},
  year    = {2019},
  doi     = {10.1161/hypertensionaha.118.12062},
  pmid    = {30624986},
  url     = {https://doi.org/10.1161/hypertensionaha.118.12062}
}

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Key findings

In a prospective national study of 22 164 blacks and whites ≥45 years without baseline cognitive impairment or stroke from the REGARDS cohort study (Reasons for Geographic and Racial Differences in Stroke), enrolled 2003 to 2007 and followed through September 2015, we measured changes in cognition associated with baseline systolic and diastolic BP (SBP and DBP), as well as pulse pressure (PP) and mean arterial pressure, and we tested whether age, race, and sex modified the effects.
Significantly faster declines in global cognition were associated with higher SBP, lower DBP, and higher PP with increasing age ( P<0.001 for age×SBP×follow-up-time, age×DBP×follow-up-time, and age×PP×follow-up-time interaction).
Declines in global cognition were not associated with mean arterial pressure after adjusting for PP.
Blacks, compared with whites, had faster declines in global cognition associated with SBP ( P=0.02) and mean arterial pressure ( P=0.04).
Men, compared with women, had faster declines in new learning associated with SBP ( P=0.04).

Why it matters

This cohort study found that higher systolic blood pressure, lower diastolic blood pressure and higher pulse pressure were associated with faster cognitive decline with increasing age. It identifies associations between blood pressure and cognition and does not test any treatment, cure or prevention.

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Study details

Study designcohort study
Participants2,003
Evidence strengthModerate

How this study scored 62/100

Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomized / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Hypertension (Dallas, Tex. : 1979))
Journal's citation record	3 / 4	Hypertension: journal h-index 369 (OpenAlex, 2026-10-29)
Study design	7 / 12	A cohort study following people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	2 / 5	2019 — within 10 year(s) of the newest study here
Sample size	3 / 4	2,003 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	0 / 2	No randomization or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	4 / 7	Cited 91 times (OpenAlex, 2026-10-10)
Citations per year	3 / 5	10.1 citations a year over 9 year(s) since 2019
Impact for its field and year	4 / 6	Cited 8.4× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	1 / 6	Cited by 2 other studies in this library
Still being cited	2 / 4	Cited 30 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Virginia G. Wadley: h-index 68 (OpenAlex, whole career)
Institution's track record	2 / 3	University of Michigan: institution h-index 2,240 (OpenAlex)
Multicenter collaboration	3 / 3	OpenAlex lists 12 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 30624986)
Free to read	0 / 2	Behind a paywall — scores zero
Total	62 / 100	—

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