The association between blood pressure variability (BPV) with dementia and cognitive function: a systematic review and meta-analysis protocol

Phillip J. Tully, Deborah A. Turnbull, Kaarin J. Anstey, Nigel Beckett, Alexa S. Beiser, Jonathan Birns, Adam M. Brickman, Nicholas R. Burns, Suzanne Cosh, Peter W. De Leeuw, Diana Dorstyn, Merrill F. Elias, J. Wouter Jukema, Kazuomi Kario, Masahiro Kikuya, Abraham A. Kroon, Lenore J. Launer, Rajiv Mahajan, Emer R. McGrath, Simon P. MooijaartEric P. Moll Van Charante, Michiaki Nagai, Toshiharu Ninomiya, Tomoyuki Ohara, Takayoshi Ohkubo, Emi Oishi, Ruth Peters, Edo Richard, Michihiro Satoh, Sudha Seshadri, David J. Stott, Willem A. Van Gool, Tessa Van Middelaar, Stella Trompet, Kristy Giles, Phoebe Drioli-Phillips, Umama Aaimir, Frank Connolly, Christophe Tzourio

Research output: Contribution to journalArticle

Abstract

Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population - adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure - any metric of BPV (systolic, diastolic or both) over any duration; comparison - persons without dementia who do not have elevated BPV; and outcome - dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.

Original languageEnglish
Article number163
JournalSystematic Reviews
Volume7
Issue number1
DOIs
Publication statusPublished - Oct 15 2018
Externally publishedYes

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Cognition
Dementia
Meta-Analysis
Blood Pressure
Databases
Hypertension
Evidence-Based Practice
Transient Ischemic Attack
MEDLINE
Antihypertensive Agents
Population
Registries
Primary Health Care
Randomized Controlled Trials
Stroke
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)

Cite this

The association between blood pressure variability (BPV) with dementia and cognitive function : a systematic review and meta-analysis protocol. / Tully, Phillip J.; Turnbull, Deborah A.; Anstey, Kaarin J.; Beckett, Nigel; Beiser, Alexa S.; Birns, Jonathan; Brickman, Adam M.; Burns, Nicholas R.; Cosh, Suzanne; De Leeuw, Peter W.; Dorstyn, Diana; Elias, Merrill F.; Wouter Jukema, J.; Kario, Kazuomi; Kikuya, Masahiro; Kroon, Abraham A.; Launer, Lenore J.; Mahajan, Rajiv; McGrath, Emer R.; Mooijaart, Simon P.; Moll Van Charante, Eric P.; Nagai, Michiaki; Ninomiya, Toshiharu; Ohara, Tomoyuki; Ohkubo, Takayoshi; Oishi, Emi; Peters, Ruth; Richard, Edo; Satoh, Michihiro; Seshadri, Sudha; Stott, David J.; Van Gool, Willem A.; Van Middelaar, Tessa; Trompet, Stella; Giles, Kristy; Drioli-Phillips, Phoebe; Aaimir, Umama; Connolly, Frank; Tzourio, Christophe.

In: Systematic Reviews, Vol. 7, No. 1, 163, 15.10.2018.

Research output: Contribution to journalArticle

Tully, PJ, Turnbull, DA, Anstey, KJ, Beckett, N, Beiser, AS, Birns, J, Brickman, AM, Burns, NR, Cosh, S, De Leeuw, PW, Dorstyn, D, Elias, MF, Wouter Jukema, J, Kario, K, Kikuya, M, Kroon, AA, Launer, LJ, Mahajan, R, McGrath, ER, Mooijaart, SP, Moll Van Charante, EP, Nagai, M, Ninomiya, T, Ohara, T, Ohkubo, T, Oishi, E, Peters, R, Richard, E, Satoh, M, Seshadri, S, Stott, DJ, Van Gool, WA, Van Middelaar, T, Trompet, S, Giles, K, Drioli-Phillips, P, Aaimir, U, Connolly, F & Tzourio, C 2018, 'The association between blood pressure variability (BPV) with dementia and cognitive function: a systematic review and meta-analysis protocol', Systematic Reviews, vol. 7, no. 1, 163. https://doi.org/10.1186/s13643-018-0811-9
Tully, Phillip J. ; Turnbull, Deborah A. ; Anstey, Kaarin J. ; Beckett, Nigel ; Beiser, Alexa S. ; Birns, Jonathan ; Brickman, Adam M. ; Burns, Nicholas R. ; Cosh, Suzanne ; De Leeuw, Peter W. ; Dorstyn, Diana ; Elias, Merrill F. ; Wouter Jukema, J. ; Kario, Kazuomi ; Kikuya, Masahiro ; Kroon, Abraham A. ; Launer, Lenore J. ; Mahajan, Rajiv ; McGrath, Emer R. ; Mooijaart, Simon P. ; Moll Van Charante, Eric P. ; Nagai, Michiaki ; Ninomiya, Toshiharu ; Ohara, Tomoyuki ; Ohkubo, Takayoshi ; Oishi, Emi ; Peters, Ruth ; Richard, Edo ; Satoh, Michihiro ; Seshadri, Sudha ; Stott, David J. ; Van Gool, Willem A. ; Van Middelaar, Tessa ; Trompet, Stella ; Giles, Kristy ; Drioli-Phillips, Phoebe ; Aaimir, Umama ; Connolly, Frank ; Tzourio, Christophe. / The association between blood pressure variability (BPV) with dementia and cognitive function : a systematic review and meta-analysis protocol. In: Systematic Reviews. 2018 ; Vol. 7, No. 1.
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abstract = "Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population - adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure - any metric of BPV (systolic, diastolic or both) over any duration; comparison - persons without dementia who do not have elevated BPV; and outcome - dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.",
author = "Tully, {Phillip J.} and Turnbull, {Deborah A.} and Anstey, {Kaarin J.} and Nigel Beckett and Beiser, {Alexa S.} and Jonathan Birns and Brickman, {Adam M.} and Burns, {Nicholas R.} and Suzanne Cosh and {De Leeuw}, {Peter W.} and Diana Dorstyn and Elias, {Merrill F.} and {Wouter Jukema}, J. and Kazuomi Kario and Masahiro Kikuya and Kroon, {Abraham A.} and Launer, {Lenore J.} and Rajiv Mahajan and McGrath, {Emer R.} and Mooijaart, {Simon P.} and {Moll Van Charante}, {Eric P.} and Michiaki Nagai and Toshiharu Ninomiya and Tomoyuki Ohara and Takayoshi Ohkubo and Emi Oishi and Ruth Peters and Edo Richard and Michihiro Satoh and Sudha Seshadri and Stott, {David J.} and {Van Gool}, {Willem A.} and {Van Middelaar}, Tessa and Stella Trompet and Kristy Giles and Phoebe Drioli-Phillips and Umama Aaimir and Frank Connolly and Christophe Tzourio",
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TY - JOUR

T1 - The association between blood pressure variability (BPV) with dementia and cognitive function

T2 - a systematic review and meta-analysis protocol

AU - Tully, Phillip J.

AU - Turnbull, Deborah A.

AU - Anstey, Kaarin J.

AU - Beckett, Nigel

AU - Beiser, Alexa S.

AU - Birns, Jonathan

AU - Brickman, Adam M.

AU - Burns, Nicholas R.

AU - Cosh, Suzanne

AU - De Leeuw, Peter W.

AU - Dorstyn, Diana

AU - Elias, Merrill F.

AU - Wouter Jukema, J.

AU - Kario, Kazuomi

AU - Kikuya, Masahiro

AU - Kroon, Abraham A.

AU - Launer, Lenore J.

AU - Mahajan, Rajiv

AU - McGrath, Emer R.

AU - Mooijaart, Simon P.

AU - Moll Van Charante, Eric P.

AU - Nagai, Michiaki

AU - Ninomiya, Toshiharu

AU - Ohara, Tomoyuki

AU - Ohkubo, Takayoshi

AU - Oishi, Emi

AU - Peters, Ruth

AU - Richard, Edo

AU - Satoh, Michihiro

AU - Seshadri, Sudha

AU - Stott, David J.

AU - Van Gool, Willem A.

AU - Van Middelaar, Tessa

AU - Trompet, Stella

AU - Giles, Kristy

AU - Drioli-Phillips, Phoebe

AU - Aaimir, Umama

AU - Connolly, Frank

AU - Tzourio, Christophe

PY - 2018/10/15

Y1 - 2018/10/15

N2 - Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population - adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure - any metric of BPV (systolic, diastolic or both) over any duration; comparison - persons without dementia who do not have elevated BPV; and outcome - dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.

AB - Background: A body of empirical work demonstrates that wide fluctuations in a person's blood pressure across consecutive measures, known as blood pressure variability (BPV), hold prognostic value to predict stroke and transient ischemic attack. However, the magnitude of association between BPV and other neurological outcomes remains less clear. This systematic review aims to pool together data regarding BPV with respect to incident dementia, cognitive impairment, and cognitive function. Methods: Electronic databases (MEDLINE, EMBASE, and SCOPUS) will be searched for the key words blood pressure variability and outcomes of dementia, cognitive impairment, and cognitive function. Authors and reference lists of included studies will also be contacted to identify additional published and unpublished studies. Eligibility criteria are as follows: population - adult humans (over 18 years but with no upper age limit) without dementia at baseline, with or without elevated blood pressure, or from hypertensive populations (systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg or use of antihypertensive drug for hypertension) and from primary care, community cohort, electronic database registry, or randomized controlled trial (RCT); exposure - any metric of BPV (systolic, diastolic or both) over any duration; comparison - persons without dementia who do not have elevated BPV; and outcome - dementia, cognitive impairment, cognitive function at follow-up from standardized neurological assessment, or cognitive testing. Article screening will be undertaken by two independent reviewers with disagreements resolved through discussion. Data extraction will include original data specified as hazard ratios, odds ratios, correlations, regression coefficients, and original cell data if available. Risk of bias assessment will be undertaken by two independent reviewers. Meta-analytic methods will be used to synthesize the data collected relating to the neurological outcomes with Comprehensive Meta-Analysis Version 2.0 (Biostat Inc., Engelwood, NJ). Discussion: This systematic review aims to clarify whether BPV is associated with elevated risk for dementia, cognitive impairment, and cognitive function. An evaluation of the etiological links between BPV with incident dementia might inform evidence-based clinical practice and policy concerning blood pressure measurement and hypertension management. The review will identify sources of heterogeneity and may inform decisions on whether it is feasible and desirable to proceed with an individual participant data meta-analysis.

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