Pulse pressure is associated with cognitive performance in Japanese non-demented population: a cross-sectional study

Control of Pulse Pressure and Factors Affecting it among the Geriatric Population Suffering from Hypertension within the Community

Background

To explore the impact of employing the Knowledge, Attitude, and Practice (KAP) model within a unified community physician intervention aimed at managing pulse pressure among elderly individuals with hypertension in Shenyang, along with its associated influencing variables.

Methods

2660 hypertensive patients were recruited in the community of Shenyang City in January 2020. After a 1-year KAP intervention by a unified community physician, KAP changes and pulse pressure levels were compared before and after the intervention. Meanwhile, the relevant influences affecting pulse pressure control were explored. Descriptive analysis and multifactorial logistic regression were used.

Results

A significant decrease in pulse pressure by 10.71 mmHg (95% CI: 10.09, 11.33 mmHg) was noted among elderly individuals with hypertension in the community after undergoing a rigorous one-year intervention program (t = 33.79, p < 0.05). Pulse pressure control increased from 32.59% at baseline to 64.92% (χ2 = 556.43, p < 0.01). Compared to pre-intervention, knowledge about hypertension, awareness of prevention, medication and behavioural adherence improved significantly. A multifactorial logistic regression analysis revealed that the risk factors for pulse pressure control were female sex, a history of comorbid diabetes mellitus and poor adherence to medication due to forgetfulness.

Conclusions

Unified community physician interventions can change the perceptions of elderly hypertensive patients, improve medication adherence, and improve poor lifestyle habits, thereby improving pulse pressure control in the geriatric population with hypertension residing in local communities.

Mediating role of inflammatory indicators in the association between sleep status and blood pressure in centenarians: evidence from China Hainan Centenarian Cohort Study

Objectives

To conduct a comprehensive analysis in Hainan centenarians on the link between sleep status and their blood pressure status. Furthermore, the study also aims to explore how inflammatory indicators may mediate the relationship.

Methods

The China Hainan Centenarians Cohort Study (CHCCS) collected baseline data on sleep status, inflammatory indicators, and blood pressure data. The study used a mediation model to investigate how inflammatory indicators mediate the relationship between sleep status and blood pressure status.

Result

In this study, a total of 967 centenarians were included. The prevalence of hypertension among the centenarians was 71.4%. The analysis showed that centenarians with poor sleep quality had a 43% higher risk of hypertension compared to those with normal sleep quality (OR = 1.43, 95% CI: 1.03-1.97). Additionally, centenarians with nighttime sleep durations of ≤ 6 h or > 9 h had higher proportions of high pulse pressure (PP), with OR values of 1.76 (95% CI: 1.18-2.63) and 2.07 (95% CI: 1.34-3.19), respectively. Mediation analysis illustrated that complement C3 played a mediating role in the relationship between sleep quality and hypertension, with an effect ratio of 2.4%. Similarly, lymphocyte count, the neutrophil-to-lymphocyte ratio (NLR), and the systemic immune-inflammation index (SII) were identified as mediating factors in the association between nighttime sleep duration and high PP, with effect ratios of 91.22%, 36.93%, and 0.20%, respectively.

Conclusion

In centenarians, poor sleep quality raises the risk of hypertension, with complement C3 as a mediator. Additionally, nighttime sleep durations of ≤ 6 h or > 9 h increases the risk of high PP, mediated by lymphocyte count, NLR, and SII.

Qigong Training Effects on Brain-Derived Neurotrophic Factor and Cognitive Functions in Sedentary Middle-Aged and Elderly Females With Type 2 Diabetes

Type 2 diabetes mellitus (T2DM) heightens dementia and cognitive decline risk, notably impacting working memory and executive functions. This study investigates the impact of 8 weeks of qigong training on cognitive functions, blood pressure, plasma brain-derived neurotrophic factor (pBDNF), antioxidant, and biochemical outcomes in sedentary middle-aged and elderly women with T2DM. Thirty-five sedentary middle-aged and elderly women with T2DM were assigned to qigong exercise (QG = 19) or control (CG = 16) groups. Qigong exercise group performed the qigong exercise three times per week, for 8 weeks. The cognitive functions and pBDNF as primary and secondary outcomes (blood pressure parameters, antioxidant, and blood cell indices) were measured at baseline and postexercise training. While cognitive performance did not change, there was a significant interaction (Group × Time), indicating reduced pBDNF levels postintervention in the qigong exercise group (p < .05). Both mean arterial blood and pulse pressure values decreased after qigong training (p < .05), but no significant interaction effects (Time × Group) were seen. There was a pulse pressure reduction after qigong training (p < .05), which was significantly correlated with the increase in longest digit span forward (r = −.34, p < .05). Antioxidant levels decreased from PRE to POST within both groups. This study demonstrated that 8 weeks of qigong training reduced pBDNF levels in sedentary middle-aged and elderly women with T2DM, which is unrelated to cognitive function improvements but possibly indicating a favorable response to exercise. Additionally, reduced blood and pulse pressure, potentially enhancing cognitive function by favorably impacting the autonomic nervous system by qigong training.

Cerebral microcirculatory pulse wave propagation and pulse wave amplitude mapping in retrospectively gated MRI

To analyze cerebral arteriovenous pulse propagation and to generate phase-resolved pulse amplitude maps from a fast gradient-echo sequence offering flow-related enhancement (FREE). Brain MRI was performed using a balanced steady-state free precession sequence at 3T followed by retrospective k-space gating. The time interval of the pulse wave between anterior-, middle- and posterior cerebral artery territories and the superior sagittal sinus were calculated and compared between and older and younger groups within 24 healthy volunteers. Pulse amplitude maps were generated and compared to pseudo-Continuous Arterial Spin Labeling (pCASL) MRI maps by voxel-wise Pearson correlation, Sørensen-Dice maps and in regards to signal contrast. The arteriovenous delays between all vascular territories and the superior sagittal sinus were significantly shorter in the older age group (11 individuals, ≥ 31 years) ranging between 169 ± 112 and 246 ± 299 ms versus 286 ± 244 to 419 ± 299 ms in the younger age group (13 individuals) (P ≤ 0.04). The voxel-wise pulse wave amplitude values and perfusion-weighted pCASL values correlated significantly (Pearson-r = 0.33, P < 0.01). Mean Dice overlaps of high (gray) and low (white matter) regions were 73 ± 3% and 59 ± 5%. No differences in image contrast were seen in the whole brain and the white matter, but significantly higher mean contrast of 0.73 ± 0.23% in cortical gray matter in FREE-MRI compared to 0.52 ± 0.12% in pCASL-MRI (P = 0.01). The dynamic information of flow-related enhancement allows analysis of the cerebral pulse wave propagation potentially providing information about the (micro)circulation on a regional level. However, the pulse wave amplitude reveals weaknesses in comparison to true perfusion-weighting and could rather be used to calculate a pulsatility index.

Relationship of widowhood with pulse pressure, fasting blood glucose, and mental health in older adults: a propensity matching score analysis

Background

Transitioning from marriage to widowhood presents inevitable and significant challenges for many older adults. This study explored the impact of widowhood on a range of mental health outcomes, including pulse pressure and fasting blood glucose levels, among older adults in nursing homes.

Methods

This cross-sectional study utilized cluster random sampling to recruit participants, with data analyzed from 388 older Chinese adults. Psychosocial traits were assessed using the Perceived Social Support from Family scale (PSS-Fa) for family support, the Generalized Anxiety Disorder 7-item scale (GAD-7) for anxiety symptoms, and the 9-item Patient Health Questionnaire (PHQ-9) for depressive symptoms and suicidal ideation. Propensity score matching (PSM) was employed to control for confounding factors. A multivariate linear regression analysis was performed to explore the relationship between widowhood, mental health outcomes, pulse pressure, and fasting blood glucose levels.

Results

After applying PSM, the sample size was refined to 268 (N = 134 for both married and widowed groups) from the initial 388, excluding 120 unmatched cases. Widowed older adults were found to have notably lower family support (β = -0.81, p = 0.002), increased depressive symptoms (β = 1.04, p = 0.043), elevated pulse pressure (β = 8.90, p < 0.001), and higher fasting blood glucose levels (β = 3.22, p = 0.027). These associations exhibited greater beta values compared to pre-matching analysis.

Conclusion

Our findings revealed that widowed participants had reduced family support, an increased risk of depressive symptoms, heightened pulse pressure, and elevated fasting blood glucose in comparison to their married counterparts. Interventions focusing on social support, mental health, and cardiovascular well-being could be advantageous for this at-risk group.

NHANES 2011-2014 Reveals Decreased Cognitive Performance in U.S. Older Adults with Metabolic Syndrome Combinations

A relationship between metabolic syndrome and cognitive impairment has been evidenced across research; however, conflicting results have been observed. A cross-sectional study was conducted on 3179 adults older than 60 from the 2011-2014 National Health and Nutrition Examination Survey (NHANES) to analyze the relationship between metabolic syndrome and cognitive impairment. In our results, we found that adults with abdominal obesity, high triglycerides, and low HDL cholesterol had 4.39 fewer points in the CERAD immediate recall test than adults without any metabolic syndrome factors [Beta = -4.39, SE = 1.32, 17.75 (1.36) vs. 22.14 (0.76)]. In addition, people with this metabolic syndrome combination exhibited 2.39 fewer points in the CERAD delayed recall test than those without metabolic syndrome criteria [Beta = -2.39, SE = 0.46, 4.32 (0.49) vs. 6.71 (0.30)]. It was also found that persons with high blood pressure, hyperglycemia, and low HDL-cholesterol levels reached 4.11 points less in the animal fluency test than people with no factors [Beta = -4.11, SE = 1.55, 12.67 (2.12) vs. 16.79 (1.35)]. These findings suggest that specific metabolic syndrome combinations are essential predictors of cognitive impairment. In this study, metabolic syndrome combinations that included obesity, fasting hyperglycemia, high triglycerides, and low HDL-cholesterol were among the most frequent criteria observed.

The Effectiveness of Antidiabetic Drugs in Treating Dementia: A Peek into Pharmacological and Pharmacokinetic Properties

Dementia dramatically affects the activities of daily living and quality of life; thus, many therapeutic approaches for overcoming dementia have been developed. However, an effective treatment regimen is yet to be developed. As diabetes is a well-known risk factor for dementia, drug repositioning and repurposing of antidiabetic drugs are expected to be effective dementia treatments. Several observational studies have been useful for understanding the effectiveness of antidiabetic drugs in treating dementia, but it is difficult to conclusively analyze the association between antidiabetic drug treatment and the risk of developing dementia after correcting for potential confounding factors. Mechanism-based approaches may provide a better understanding of the effectiveness of antidiabetic drugs for treating dementia. Since the peripheral circulation and the central nerve system are separated by the blood-brain barrier, it is important to understand the regulation of the central glucose metabolism. In this review, we discuss the pharmacological and pharmacokinetic properties of antidiabetic drugs in relation to treating dementia.