Cognitive impairment and dementia as well as high blood pressure disproportionately affect Blacks and Hispanics in the US. The BP COG study is an National Institutes of Health (NIH) / National Institute of Neurological Disorders and Stroke (NINDS)-funded R01 study that aims to determine the effect of high blood pressure over the life course on the risk of cognitive impairment and dementia in Blacks, Hispanics, and Whites, and to estimate the potential impact of optimal high blood pressure treatment intensity to reduce racial/ethnic disparities in cognitive impairment and dementia.

This is a multi-center study in collaboration with researchers from Columbia University and Johns Hopkins University. The study involves pooling and harmonizing data from six existing longitudinal cohorts, secondary data analysis, and simulation modeling.

The BP COG study has advanced the science of vascular cognitive impairment by determining the impact of high blood pressure on cognitive decline in Black and White individuals. The study showed that Black individuals’ higher cumulative blood pressure (BP) levels contribute to racial differences in later-life cognitive decline, published in JAMA Neurology. These results suggest that Black individuals’ worse high blood pressure control contributes to their greater dementia risk.

The study used individual participant data from six well-characterized American prospective cohort studies: 

• Atherosclerosis Risk in Communities Study (ARIC)
• Coronary Artery Risk Development in Young Adults Study (CARDIA)
• Cardiovascular Health Study (CHS)
• Framingham Offspring Study (FOS)
• Multi-Ethnic Study of Atherosclerosis (MESA)
• Northern Manhattan Study (NOMAS)

The BP COG study is an innovative national study that created harmonized and pooled, longitudinal cohorts of individuals with calibrated cognition measures from six studies. This innovation provides the sample size and race/ethnic diversity of individuals to answer scientific questions previously impossible.

The BP COG study team also developed and refined a novel simulation model that predicts dementia and cardiovascular disease events. This new simulation model translates the effects of vascular risk factor lowering on dementia into clinical practice and policy and helps plan future vascular risk factor lowering trials to reduce dementia in diverse populations.

Publications

Association between blood pressure and later-life cognition among black and white individuals
Levine DA, Gross AL, Briceño EM, et al. JAMA Neurol. 2020 Apr 13; [Epub ahead of print] PMID: 32282019/PMCID: PMC7154952

Methods and early recruitment of a community-based study of cognitive impairment among Mexican Americans and non-Hispanic whites: the BASIC-Cognitive study
Briceño EM, Mehdipanah R, Gonzales X, Heeringa S, Levine DA, Langa KM, Garcia N, Longoria R, Morgenstern LB. J Alzheimers Dis. 2020;73(1):185-196. PMID: 31771059

Neuropsychological assessment of mild cognitive impairment in Latinx adults: a scoping review.
Briceño EM, Mehdipanah R, Gonzales X, Langa KM, Levine DA, Garcia N, Longoria R, Giordani B, Heeringa S, Morgenstern L. Neuropsychology. 2020. [Epub ahead of print] PMID: 32281811