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ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 3  |  Page : 94-98

Cardiovascular disease, pulse pressure and cognitive decline in ambulatory and hospitalized old patients


1 Geriatric Rehabilitative Department for Cardiovascular Disease, Italian National Research Center on Aging, Fermo, Italy
2 Expert Center for Cognitive Disorders at Pavullo nel Frignano, Local health authority, Modena; Regional Center of Neurogenetic, Lamezia Terme, Catanzaro, Italy

Correspondence Address:
Elpidio Santillo
Contrada Mossa, Dipartimento Geriatrico Riabilitativo ad Indirizzo Cerebro-Cardiovascolare, Italian National Research Center on Aging, Contrada Mossa, Fermo - 63900
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2394-2010.168369

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Context: Correlations between hypertension, dementia, and cardiovascular diseases in elderly subjects are far from having been elucidated and to date, studies involving old patients from different care settings are lacking. Aims: We aimed to investigate the differences regarding clinical blood pressure values in old subjects from diverse settings of care (ambulatory and hospitalized) examining patients with and without cognitive decline. We wanted also to search the associations between cardiovascular disease, pulse pressure (PP), and cognitive decline in hypertensive subjects. Materials and Methods: The study retrospectively analyzed data from 320 patients (155 ambulatory and 165 hospitalized). Patients' data records were evaluated for diagnosis of cardiovascular diseases and cognitive decline. All subjects underwent blood pressure measurement with the calculation of PP. Results: Patients with dementia or mild cognitive impairment (MCI) showed a greater PP than patients without dementia or MCI (69 mmHg vs 58 mmHg, P: 0.000). In hypertensive patients (n: 219), regression analysis showed an increased risk of cognitive impairment in subjects with cardiovascular disease: odds ratio (OR) 3.65 [95% confidence interval (CI), 1.63 to 8.18], in subjects with higher PP: OR 2.34 (95% CI, 1.15 to 4.77) and in older ones OR: 1.06 (95% CI, 1.01 to 1.12). Conclusions: In our study, old subjects with cognitive impairment showed higher PP. Elderly hypertensive patients with cardiovascular disease from various care settings should always be examined to identify the trend in the development or progression of cognitive decline.


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