Is hypertension severity associated with impaired cognitive performance and altered cerebral hemodynamics compared to controls?
Higher severity of hypertension is associated with worse cognitive performance and reduced cerebral vasomotor reactivity.
B: Hypertension affects the target-organs diversely. Most evidence on target-organ damage in hypertension is related to kidney and heart. The cerebrovascular and cognitive impairment are less studied. O: To study the cognitive function changes in patients with hypertension on different stages compared to the control pairs and their correlation with the arterial stiffness properties assessed by non-invasive methods and cerebral circulation assessed by transcranial Doppler. M: In a cross sectional study 162 patients (42 controls and 120 hypertensive) were comparatively evaluated. Hypertensive patients were divided in three stages according to the blood pressure levels or medication use (HTN-1: BP 140-159/90-99 or use of one antihypertensive drug; HTN-2: BP 160-179/100-109 or use of two drugs and HTN-3: BP ≥180/110 or use of three or more drugs). The following variables were evaluated: pulse wave velocity, intima medial thickness, cerebral blood flow velocities by transcranial Doppler (TD) and cognitive function. Mean velocity of middle cerebral artery was continuously monitored at resting and during the breath holding test (30 seconds) and 3 minutes handgrip maneuver. Cognitive function was assessed by mini mental state examination and Montreal Cognitive Assessment. R: Compared to control group, HTN-3 group was older, had higher BMI, IMT and PWV and lower educational level and family income (Table 1). Interestingly, the higher the hypertension stage the poorer was the performance in cognitive tests even after age correction. There was no difference among the groups related to TD velocities at rest and the hand-grip maneuver. However, it was noted a lower breath holding index in the hypertensive group (HTN-1=0.94±0.56; HTN-3=0.97±0.59 vs Control=1.5±0.68; p=0.002) which could infer less vasomotor reactivity in these patients. C: Cognitive impairment was more frequent in patients with hypertension and this frequency was related to hypertension severity.
Muela et al. (Tue,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: