While higher morning systolic blood pressure surges (MBPS) have been associated to increased stroke risk, the association with cognitive performances remains unknown. The aim of this study is to determine which method for calculating MBPS is the best predictor of performance in task-switching and processing speed in both elderly normotensive and hypertensive subjects. One hundred and three participants between 60–75 years old were divided into three groups: normotensive subjects not receiving an anti-hypertensive treatment (n=49), hypertensive subjects receiving treatment and controlled for BP (n=28) and refractory hypertensive subjects (n=26). Subjects were evaluated for ambulatory blood pressure (BP) and cognitive functions using a battery of neuropsychological tests. Four methods for calculating MBPS (pre-waking surge, morning-evening surge, rising BP surge and sleep through surge) were selected and used individually as independent determinants in multiple-linear-regression models together with group, age, sex, years of schooling while using preselected cognitive variables as outcomes. Models using pre-waking surge (Morning BP minus Pre-awake BP) were significant predictors of “the number of errors in the Trial-Making-Test Part B(TMTB)”(p=0.018), “the number of switching errors in TMTB”(p=0.005), and “the reading condition of the Color-Word Interference Test”(p=0.031), while models using morning-evening surge (Morning BP minus Evening BP) were significant predictors of “the number of errors in TMTB”(p=0.036), “the number of switching errors in TMTB”(p=0.02). The other methods of calculating MBPS were less successful predictors. These results suggest that pre-waking surge could be used as a predictor of performance in task-switching and processing speed in elderly subjects independently of their BP-related category.
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