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Stress-induced blood pressure reactivity and cognitive function

From the Department of Psychology (Dr. Waldstein), University of Maryland, Baltimore County; Division of Gerontology (Drs. Waldstein and Katzel), Department of Medicine, University of Maryland School of Medicine; and Geriatric Research Education and Clinical Center (Drs. Waldstein and Katzel), Baltimore Veterans Affairs Medical Center, MD.

Address correspondence and reprint requests to Dr. Shari R. Waldstein, Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250; e-mail: waldstei{at}umbc.edu

Objective: To examine the relation of stress-induced blood pressure (BP) reactivity to cognitive function.

Methods: Ninety-four healthy stroke- and dementia-free middle-aged and older adults (ages 54 to 79; 62% male; 90% white) completed biomedical, psychophysiological, and neuropsychological assessment procedures.

Results: After statistical adjustment for age, education, state anxiety, fasting glucose levels, and resting systolic or diastolic BP (depending on the model), greater systolic BP reactivity was associated with decreased performance on Logical Memory–Immediate Recall (r² = 0.08; p < 0.007), Logical Memory–Delayed Recall (r² = 0.06; p < 0.02), and Stroop interference scores (r² = 0.04; p < 0.05). Enhanced diastolic BP reactivity was similarly associated with decreased performance on Logical Memory–Immediate Recall (r² = 0.06; p < 0.02) and Stroop interference scores (r² = 0.06; p < 0.02).

Conclusions: Independent of resting clinic blood pressure (BP), systolic and diastolic BP reactivity was associated with diminished performance on tests of immediate and delayed verbal memory and executive function (i.e., response inhibition), accounting for 3 to 8% of the variance in these measures.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the May 24 issue to find the title link for this article.

Supported by NIH grant R29 AG15112 and NIH K24 AG00930; and a VA Merit Grant, Bristol Myers Squibb Medical Imaging, Inc., the Department of Veterans Affairs Baltimore Geriatric Research Education and Clinical Center, and the Geriatrics and Gerontology Education and Research Program of the University of Maryland, Baltimore.

Received June 17, 2004. Accepted in final form February 4, 2005.

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