Neurocognitive disorder in hypertensive patients. Heart–Brain Study

• Published in: Hipertension y riesgo vascular Vol. 35; no. 4; pp. 169 - 176
• Main Authors: Vicario, A, Cerezo, G.H, del Sueldo, M, Zilberman, J, Pawluk, S.M, Lódolo, N, De Cerchio, A.E, Ruffa, R.M, Plunkett, R, Giuliano, M.E, Forcada, P, Hauad, S, Flores, R
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España, S.L.U 01.10.2018
• Subjects: Age Factors; Aged; Anthropometry; Argentina - epidemiology; Blood Pressure; Cardiovascular; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - etiology; Cognitive impairment; Cross-Sectional Studies; Deterioro cognitivo; Disfunción ejecutiva; Executive dysfunction; Executive Function; Factores de riesgo vascular; Female; Hipertensión; Humans; Hypertension; Hypertension - complications; Hypertension - psychology; Male; Memoria semántica; Memory Disorders - diagnostic imaging; Memory Disorders - etiology; Mental Status and Dementia Tests; Middle Aged; Risk Factors; Semantic memory; Sex Factors; Urban Population; Vascular risk factors; Argentina; Semantic memory; HTN; Mini-BNT; systolic blood pressure; BP; Executive dysfunction; CDT; DBP; diastolic blood pressure; MMSE; Mini-Boston Naming Test; SBP; Clock Drawing Test; blood pressure; Disfunción ejecutiva; CI; HADS; Hipertensión; MCE; Hospital Anxiety and Depression Scale; minimal cognitive examination; Memoria semántica; Deterioro cognitivo; Factores de riesgo vascular; cognitive impairment; Mini Mental State Examination; hypertension; Vascular risk factors; Hypertension; Cognitive impairment
• ISSN: 1889-1837; 1989-4805
• DOI: 10.1016/j.hipert.2018.01.004

Abstract The relation between hypertension and cognitive impairment is an undisputable fact. The aims of this study were to determine the prevalence of cognitive impairment in hypertensive patients, to identify the most affected cognitive domain, and to observe the association with different parameters of hypertension and other vascular risk factors. A multicentre study was carried out, and 1281 hypertensive patients of both genders and ≥21 years of age were included. Data on the following parameters were obtained: cognitive status (Minimal Cognitive Examination), behavioural status (Hospital Anxiety and Depression Scale), blood pressure, anthropometry, and biochemical profile. The average age was 60.2 ± 13.5 years (71% female), and the educational level was 9.9 ± 5.1 years. Global cognitive impairment was seen in 22.1%, executive dysfunction in 36.2%, and semantic memory impairment in 48.9%. Cognitive impairment was higher in males (36.8% vs. 30.06%) within both the 70–79-year-old and the ≥80-year-old (50% vs. 40%) age groups. Abnormal Clock Drawing Test results were related to high pulse pressure ( p < 0.0036), and abnormal Mini-Boston Naming Test results to both high systolic blood pressure ( p < 0.052) and pulse pressure ( p < 0.001). The treated/uncontrolled hypertensive group showed abnormal results both in the Mini Mental State Examination (OR, 0.73; p = 0.036) and the Mini-Boston Naming Test (OR, 1.36; p = 0.021). Among patients without cognitive impairment (MMSE >24), 29.4% presented executive dysfunction, and 41.5% semantic memory impairment. Cognitive impairment was higher in hypertensive patients than in the general population. Executive functions and semantic memory were the most affected cognitive domains. High systolic blood pressure and pulse pressure were associated with abnormal results in cognitive tests.