Hypertension and the effect of hypertension on cognitive decline using NACC UDS
  
   Lead Investigator:    Kyle Steenland
   Institution      :    Emory
   E-Mail           :    nsteenl@emory.edu
   Proposal ID      :    130


   Publications:


1  Goldstein FC, Levey AI, Steenland NK
   High blood pressure and cognitive decline in mild cognitive impairment
   Journal Article  J Am Geriatr Soc,61:67-73,2013,PMC3699694

   PUBLISHED





   Proposal Description:
   We have several goals. First we want to assess whether subjects with a history    of hypertension, decline faster over time if their hypertension is not            controlled.  These would be longitudinal analyses in which hypertensives,         either normal or MCI at first visit, are divided into ???well controlled??? (no   systolic above 140 and no diastolic above 90), and not well controlled (one       more more instances of measured high blood pressure across visits).   The         outcome of interest would either be decline on cognitive tests or a transition    to a worse diagnosis (eg, from normal to MCI or dementia, from MCI to             dementia).  Analyses would use either SAS PROC MIXED for the cognitive decline    outcome, or SAS PHREG (survival analysis) for the outcome of transition to a      worse diagnosis.  We also want to determine whether use of centrally acting ACE   inhibitors  (captropril, fosinopril, liniopril, perindopril, ramipril,            trandolapril) provide protection against cognitive decline), as indicated by a    recent report (Sink et al, Arch Int Med 2009, attached).   Here again the         design would consider cognitive decline in terms of cognitive tests and also in   terms of a transition to a worse diagnosis, as described above.  Hypertensives    taking centrally-acting ACE inhibitors will be compared to hypertensives taking   other types of ACE inhibitors and other types of blood pressure-lowering          medications. Using the dataset related to: