Slower speed of blood pressure recovery after standing is associated with accelerated brain ageing: Evidence from The Irish Longitudinal Study on Ageing (TILDA)

• Published in: Cerebral circulation - cognition and behavior 2024-01, Vol.6, p.100212-100212, Article 100212
• Main Authors: A． Shirsath, Morgana, O'Connor, John D., Boyle, Rory, Newman, Louise, Knight, Silvin P., Hernandez, Belinda, Whelan, Robert, Meaney, James F., Kenny, Rose Anne
• Format: Article
• Language: English
• Subjects: Active stand; Brain ageing; Cerebral autoregulation; Orthostatic hypotension
• ISSN: 2666-2450; 2666-2450
• DOI: 10.1016/j.cccb.2024.100212

•Impaired recovery of systolic and diastolic blood pressure after standing is associated with accelerated brain ageing, determined using the BrainPAD model.•No association was found between heart rate recovery and brain age acceleration.•Evaluation of the response of blood pressure to active standing may be an indicator of brain health, and accelerated brain ageing. Impaired recovery of blood pressure (BP) in response to standing up is a prevalent condition in older individuals. We evaluated the relationship between the early recovery of hemodynamic responses to standing and brain health in adults over 50. Participants from The Irish Longitudinal Study on Ageing (TILDA) (n=411; age 67.6 ± 7.3 years; 53.4 % women) performed an active stand challenge while blood pressure and heart rate were continuously monitored. The recovery of these parameters was determined as the slope of the BP and HR response, following the initial drop/rise after standing. We have previously reported a novel and validated measure of brain ageing using MRI data, which measures the difference between biological brain age and chronological age, providing a brain-predicted age difference (brainPAD) score. Slower recovery of systolic and diastolic BP was found to be significantly associated with higher brainPAD scores (i.e., biologically older brains), where a one-year increase in brainPAD was associated with a decrease of 0.02 mmHg/s and 0.01 mmHg/s in systolic and diastolic BP recovery, respectively, after standing. Heart rate (HR) recovery was not significantly associated with brainPAD score. These results demonstrate that slower systolic and diastolic BP recovery in the early phase after standing is associated with accelerated brain ageing in older individuals. This suggests that the BP response to standing, measured using beat-to-beat monitoring, has the potential to be used as a marker of accelerated brain ageing, relying on a simple procedure and devices that are easily accessible. [Display omitted]