Long-term effect of hypertension on neurobehavioral and cardiac function in the apparently healthy community-dwelling elderly a 5-year follow-up study

• Published in: Nihon Rōnen Igakkai zasshi Vol. 40; no. 4; pp. 375 - 380
• Main Authors: Chikamori, Taishiro, Doi, Yoshinori, Nishinaga, Masanori, Hamada, Tomio
• Format: Journal Article
• Language: Japanese
• Published: Japan The Japan Geriatrics Society 01.07.2003
• Subjects: Activities of Daily Living; Activities of daily living (ADL); Aged; Aged, 80 and over; Behavior; Cognition Disorders - etiology; Cognitive-neurobehavioral function; Community-dwelling elderly; Female; Follow-Up Studies; Heart - physiopathology; Humans; Hypertension; Hypertension - physiopathology; Hypertension - psychology; Longitudinal study; Male; Middle Aged; Neuropsychological Tests
• ISSN: 0300-9173
• DOI: 10.3143/geriatrics.40.375

Recently, it has been reported that hypertension causes not only cerebro-cardiovascular diseases, but also a decline of cognitive function in the elderly. However, it is not clear whether or not aging and hypertension have a latent effect on the cognitive-neurobehavioral and cardiac functions in healthy elderly whose scores of basic activities of daily living (ADL) are fully maintained. We evaluated the effect of aging and hypertension on cognitive-neurobehavioral and cardiac functions in 25 healthy community-dwelling elderly subjects (mean age: 69 y. o.) whose scores of basic ADL were fully maintained. Subjects were followed over a 5-year period, and the following examinations were performed before and after a 5-year follow-up; echocardiography, 24-hr ambulatory blood pressure monitoring (ABPM), and cognitive-neurobehavioral function test. Left ventricular mass index was significantly increased in the hypertensive (HT) subjects relative to the normotensive (NT) subjects over the 5 years (% change: +5.3% for HT vs. -0.8% for NT, p=0.03). The number of non-dippers significantly increased over the 5 years in the HT group (initially: 20% [2/10] vs. follow-up: 58% [7/12], p=0.04). Visuospatial cognitive performance scale scores for evaluation of higher cognitive-neurobehavioral functions significantly deteriorated in the HT subjects (initially: 2, 344±110 vs. 2, 380±102, ns, and follow-up: 2, 149±181 vs. 2, 356±159, p=0.04). Hypertension contributes to the impairment of the cognitive-neurobehavioral function in the elderly by latently affecting the functions of multiple organs. This occurs even if basic ADL is maintained for 5 years. Therefore, it is important to control BP not only to prevent cardiovascular events, but also to preserve the neurobehavioral function.