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

PatternHazard Ratio (95% CI)
UnadjustedaModel 1bModel 2cModel 3d
By dipping patterne
 Normal dippingReferenceReferenceReferenceReference
 Reverse dipping2.28 (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)
 Nondippers1.79 (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 dipping1.41 (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 hypertensionReferenceReferenceReferenceReference
 White-coat hypertension1.49 (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 hypertension1.34 (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 hypertension2.26 (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.

  • a Unadjusted: adjusting for clinic site.

  • b Model 1: adjusting for age, race, sex, education, marital status, and income.

  • c Model 2: adjusted for model 1 plus smoking, alcohol use, and illicit drug use.

  • d 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.

  • e 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.