Fluctuating blood pressure can increase the risk of dementia and vascular problems in older people, a new study by researchers has warned.

Short blood pressure (BP) fluctuations within 24 hours as well as over several days or weeks are linked with impaired cognition, according to University of South Australia (UniSA) researchers who led the study.

Higher systolic BP variations (the top number that measures the pressure in arteries when a heart beats) are also linked with stiffening of the arteries, associated with heart disease.

It is well known that high blood pressure is a risk factor for dementia, but little attention is paid to fluctuating blood pressure.

“Clinical treatments focus on hypertension while ignoring the variability of blood pressure,” lead author Daria Gutteridge said in the paper published in the journal Cerebral Circulation – Cognition and Behaviour. “

Blood pressure can fluctuate across different time frames – short and long – and this appears to heighten the risk of dementia and blood vessel health,” Gutteridge added.

To help explore the mechanisms that link BP fluctuations with dementia, the researchers recruited 70 healthy older adults aged 60-80 years, with no signs of dementia or cognitive impairment.

Their blood pressure was monitored, they completed a cognitive test, and their arterial stiffness in the brain and arteries was measured using transcranial Doppler sonography and pulse wave analysis.

“We found that higher blood pressure variability within a day, as well as across days, was linked with reduced cognitive performance. We also found that higher blood pressure variations within the systolic BP were linked with higher blood vessel stiffness in the arteries,” the authors wrote.

These results indicate that the different types of BP variability likely reflect different underlying biological mechanisms, and that systolic and diastolic blood pressure variation are both important for cognitive functioning in older adults, they noted.

BP variability could potentially serve as an early clinical marker or treatment target for cognitive impairment, the researchers said.