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How Does Race Influence the Hypertension–Cognition Link? Evidence From Two Community-Level Cohort Studies

Poster Session C - Sunday, March 8, 2026, 5:00 – 7:00 pm PDT, Fairview/Kitsilano Ballroom

Michael Oliver¹ (), Jessica Hocking¹, Katja Gehr¹, Marquinta Harvey¹; ¹Belmont University

The 2025 American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines highlight systolic blood pressure’s (SBP) role in preventing cognitive impairment. Research supports a direct link between hypertension and cognitive decline; however, this relationship may not function similarly across race. Hypertension is more common in minority racial groups, with 2-3 times greater prevalence than in White individuals. Often attributed to race, these differences may be more complex than previously thought. This work intends to answer two questions highlighting how race is related to hypertension and cognitive decline: 1) does race increase risk for hypertension then lead to cognitive impairment, implying a downstream/cascading effect of race? and 2) does race intensify the existing relationship between hypertension and cognitive impairment, implying a compounding effect of race? To address these questions, we utilized community-level data from 2 publicly-available datasets across varying age groups (i.e., middle-aged adults – Offspring: N=269 and older adults – Rush: N=4,828). Results revealed higher SBP was associated with worse cognition regardless of race. Across both cohorts, SBP mediated the relationship between race and domain-specific cognitive abilities; however, no race differences existed between domain-specific or global cognitive abilities and SBP. Findings suggest elevated SBP is a risk factor for cognitive decline functioning independent of race, although race-related experiences may contribute to hypertension, causing a downstream effect on cognition. Race is a social construct that may serve as a proxy for other direct moderators on cognition, but race alone does not affect the relationship between hypertension and cognition.

Topic Area: LONG-TERM MEMORY: Development & aging