The relationship between cognitive functioning and the jnc-8 guidelines for hypertension in older adults

Felicia C. Goldstein, Ihab M. Hajjar, Callie B. Dunn, Allan I. Levey, Whitney Wharton

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: Guidelines for hypertension treatment by the Eighth Joint National Committee (JNC-8) in 2014 recommended a target systolic blood pressure (BP) of <150/<90 mmHg in persons older than 60 years, in contrast to the 2003 JNC-7 recommendations of systolic BP <140 mmHg. This study evaluated the implications of raising the BP target on cognitive functioning and conversion from normal cognition to mild cognitive impairment (MCI). Methods: This was a longitudinal study of individuals older than 60 years enrolled in the NIH-NIA Alzheimer's Disease Centers. All had normal cognition at baseline. 453 participants were taking BP medications and had readings of <140/<90 mmHg at four annual visits (reference group). Two other groups consisted of participants with either systolic BP of 140-149 mmHg (n = 112) or ?150 mmHg (n = 280) on three or four annual visits. Results: Compared with the reference and the 140-149 mmHg groups, those with BP ?150 mmHg exhibited poorer cognitive status by Year 4 on the Mini-Mental State Exam, and they had a higher risk of conversion to MCI. The 140-149 mmHg exhibited poorer performance than the reference group on domains assessing attention and executive functioning. In contrast, their performance was not significantly different from those with BP ?150 mmHg. Conclusions: Persons with BP ?150 mmHg show a faster global cognitive decline and transition to MCI than those with lower BP readings. However, the poor cognitive performance in the attention and executive functioning domains for the 140-149 mmHg group indicates the need for further research evaluating the newer recommended cutoff.

Original languageEnglish (US)
Pages (from-to)121-126
Number of pages6
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number1
StatePublished - Jan 2017
Externally publishedYes


  • Cognitive functioning
  • Hypertension
  • JNC-8 Guidelines
  • Mild cognitive impairment
  • Older adults

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


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