Multiple drug intolerance syndrome in hypertensive patients was associated with significantly slower processing speed on the Color Trails Test compared to controls (median 66.5 vs 51.5 seconds; p=0.006).
Case-Control (n=84)
No
Does multiple drug intolerance syndrome worsen cognitive impairment in hypertensive patients?
Hypertensive patients with multiple drug intolerance syndrome show complex cognitive changes, with impaired processing speed but potentially preserved or better attention and attentional shifting compared to those without MDIS.
Absolute Event Rate: 66.5% vs 51.5%
p-value: p=0.006
Objective: Cognitive impairment (CI) is a considerable and well-known complication of hypertension. Intolerance to antihypertensive medications is common and often results in poor adherence to treatment, which might lead to more pronounced organ damage. Multiple drug intolerance syndrome (MDIS) is a condition in which intolerance to three or more medications can be identified. The aim of this study was to evaluate the extent of CI in hypertensive patients with MDIS compared with those without MDIS. Design and method: This was a case-control study. MDIS patients were recruited from one university outpatient clinic, and the control group was matched based on age and education level. Each patient underwent neuropsychological tests assessing mainly the frontal cortex – Montreal Cognitive Assessment (MoCA), Wisconsin Card Sorting Test (WCST), Color Trails Test (CTT), Frontal Assessment Battery (FAB), and Attention and Perception Test. Results: The study included 84 patients – 43 in the MDIS group and 41 in the control group. The majority of patients were female, and the median (Q1-Q3) age was 68.5 (62-73) years. Patients with MDIS had an intolerance to a median of 4.5 drugs. MDIS patients performed significantly worse in the first task of CTT (CTT-1) (median time (Q1-Q3): 66.5 (52-84) vs. 51.5 (42.5-59.5) seconds, p=0.006). On the other hand, the MDIS group had a lower median CTT interference index (0.86 (0.53-1.36) vs. 1.17 (0.86-1.77), p=0.019). MDIS group also scored better in the attention domain of MoCA (median score: 6 (5-6) vs. 5 (5-6); p=0.035) and in the fluency domain of FAB (median score: 3 (3-3) vs. 3 (2-3), p=0.038). There were no significant differences in WCST domains and in the Attention and Perception Test. Conclusions: Hypertensive patients with MDIS showed significant impairment in processing speed (assessed by CTT-1). Nevertheless, this group tends to have less impaired attention and attentional shifting than patients without MDIS. These results show that the problem is complex, and an unambiguous relationship between CI and MDIS cannot be assumed.
Rusinek-Glück et al. (Fri,) conducted a case-control in Hypertension with multiple drug intolerance syndrome (n=84). Multiple drug intolerance syndrome (MDIS) vs. Hypertensive patients without MDIS was evaluated on Processing speed assessed by the first task of the Color Trails Test (CTT-1) in seconds (p=0.006). Multiple drug intolerance syndrome in hypertensive patients was associated with significantly slower processing speed on the Color Trails Test compared to controls (median 66.5 vs 51.5 seconds; p=0.006).