Table 4.
Hazard ratio and 95% confidence interval for incident cognitive impairment by dipping and BP patterns from discrete Cox proportional hazard models over 4 years of follow-up from time of ambulatory BP monitoring
| Pattern | Hazard Ratio (95% CI) | |||
|---|---|---|---|---|
| Unadjusted a | Model 1 b | Model 2 c | Model 3 d | |
| By dipping pattern e | ||||
| Normal dipping | Reference | Reference | Reference | Reference |
| Reverse dipping | 2.28 (1.53 to 3.41) | 1.49 (0.97 to 2.29) | 1.43 (0.92 to 2.21) | 1.29 (0.81 to 2.05) |
| Nondippers | 1.79 (1.26 to 2.54) | 1.38 (0.95 to 1.99) | 1.31 (0.90 to 1.91) | 1.32 (0.89 to 1.97) |
| Extreme dipping | 1.41 (0.81 to 2.43) | 1.62 (0.89 to 2.91) | 1.58 (0.88 to 2.83) | 1.83 (0.99 to 3.34) |
| By BP pattern | ||||
| Controlled hypertension | Reference | Reference | Reference | Reference |
| White-coat hypertension | 1.49 (0.78 to 2.83) | 0.86 (0.42 to 1.73) | 0.88 (0.43 to 1.78) | 0.93 (0.45 to 1.92) |
| Masked hypertension | 1.34 (0.95 to 1.89) | 0.94 (0.65 to 1.36) | 0.96 (0.66 to 1.40) | 0.96 (0.64 to 1.42) |
| Sustained hypertension | 2.26 (1.61 to 3.18) | 0.98 (0.68 to 1.42) | 0.98 (0.68 to 1.42) | 0.86 (0.57 to 1.29) |
P value for proportional hazard assumption (dipping patterns)=0.86. P value for proportional hazard assumption (BP patterns)=0.98. 3MS, Modified Mini Mental State Examination.
Unadjusted: adjusting for clinic site.
Model 1: adjusting for age, race, sex, education, marital status, and income.
Model 2: adjusted for model 1 plus smoking, alcohol use, and illicit drug use.
Model 3: adjusted for model 2 plus body mass index, use of antihypertensive medications, history of hypertension, diabetes mellitus, hyperlipidemia, anemia, C-reactive protein, urine protein-creatinine ratio, depression, stroke, and GFR at time of ambulatory BP.
Clinically significant cognitive impairment based on 3MS: 3MS score <85 for participants younger than 65, <80 for participants aged 65–79, and <75 for those 80 yr or older.