We have several blood pressure cuffs in various areas around the house. My dad has high blood pressure so he regularly checks his resting blood pressure several times a day, most often while sitting at the breakfast table. However, research is finding that this type of measurement may not be the best kind to predict brain disease and cognitive decline.
A recent small study published in Circulation: Journal of the American Heart Association found that ambulatory blood pressure may be the best predictor of the progression of small blood vessel brain disease and cognitive decline in older people. Whereas in-office blood pressure is taken in a healthcare provider’s office (and is mimicked when my dad takes his regular assessments), ambulatory blood pressure is measured through monitoring blood pressure regularly with a special recording device.
“An ambulatory blood pressure monitor is a small machine, about the size of a portable radio,” Family Doctor.org reports. “You wear it on a belt. The blood pressure cuff on the monitor can be worn under your clothes without anyone seeing it.” The machine collects readings every 15-30 minutes. In addition, the patient is asked to keep a journal describing daily activities that allows the doctor to see when the patient was active or resting. “After 24 hours of monitoring, you will take the machine and your diary to the doctor's office,” FamilyDoctor.org explained. “The blood pressure information is transferred from the monitor to a computer. The computer helps the doctor make sense of the information. Your doctor will review the information with you and decide if your treatment program is working or if you need to make changes.”
In the study that was reported on the American Heart Association (AHA) website, researchers followed 72 participants, averaging 82 years of age, over a two-year period. The scientists evaluated the effect that blood pressure had on brain disease through examining the change in blood pressure and the volume of white matter hyperintensities (WMH) at both the beginning of the study and the end of the study. (WMH can be detected by an MRI and indicates small vessel brain damage. The researchers also measured cognitive ability and physical mobilitiy during the two-year period.
The scientists found that there was an association between worsening ambulatory blood pressure, an increase in WMH and a decrease in cognitive and mobility functions. Interestingly, the researchers also found that there was no relationship between clinical blood pressure and WMH. They believe that if ambulatory blood pressure can be controlled, the progression of small vessel brain disease can be reduced.
The study also found that the average volume of WMH increased significantly over the two-year period when calculations were adjusted for age and “bad” LDL cholesterol. “Three of the four mobility measures and all of the cognitive measures were significantly related to WMH volume at two years,” the AHA website also reported.
