Supplemental Digital Content is available in the text. To investigate the association between visit-to-visit variability in blood pressure and the incidence of dementia and its subtypes in a general population, we conducted a population-based retrospective cohort study using the Korean National Health Insurance System database. We identified 7 844 814 subjects without a history of any dementia who underwent ≥3 health examinations from 2005 to 2012 in the Korean National Health Insurance System cohort. Blood pressure variability (BPV) was measured using the variability independent of the mean, coefficient of variation, and SD. During the median follow-up of 6.2 years, there were 200 574 cases of all-cause dementia (2.8%), 165 112 cases of Alzheimer’s disease (2.1%), and 27 443 cases of vascular dementia (0.3%). There was a linear association between higher BPV and outcome measures. In the multivariable adjusted model, the hazard ratios and 95% CIs of all-cause dementia were 1.06 (1.04–1.07) for the highest quartile of variability independent of the mean of diastolic blood pressure only, 1.09 (1.08–1.11) for that of systolic blood pressure only, and 1.18 (1.16–1.19) for that of both systolic and diastolic blood pressure compared with subjects having no highest quartile for BPV. Consistent results were noted for Alzheimer’s disease and vascular dementia using other indices of variability and in various sensitivity and subgroup analyses. BPV is an independent predictor for developing dementia and its subtypes. A dose-response relationship was noted between higher BPV and dementia incidence. Reducing BPV may be a target for preventing dementia in the general population.

中文翻译：

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血压变异性和痴呆症的风险

补充数字内容在文本中可用。为了调查血压的访问间差异与一般人群中痴呆及其亚型的发病率之间的关联，我们使用韩国国民健康保险系统数据库进行了一项基于人群的回顾性队列研究。我们确定了 7 844 814 名没有痴呆病史的受试者，他们在 2005 年至 2012 年期间在韩国国民健康保险系统队列中接受了≥3 次健康检查。使用独立于平均值、变异系数和 SD 的变异性来测量血压变异性 (BPV)。中位随访6.2年，全因痴呆200574例（2.8%），阿尔茨海默病165112例（2.1%），血管性痴呆27443例（0.3%）。较高的 BPV 与结果指标之间存在线性关联。在多变量调整模型中，最高四分位数变异性的全因痴呆的风险比和 95% CI 为 1.06 (1.04–1.07)，仅与舒张压的平均值无关，1.09 (1.08–1.11) 为 1.09 (1.08–1.11)仅收缩压，收缩压和舒张压的收缩压均为 1.18 (1.16–1.19)，而与 BPV 没有最高四分位数的受试者相比。使用其他可变性指数以及各种敏感性和亚组分析，阿尔茨海默病和血管性痴呆的结果一致。BPV 是发展为痴呆及其亚型的独立预测因子。注意到较高的 BPV 和痴呆发病率之间存在剂量反应关系。