Cognitive Impairment and Cerebral Ischemia in Arterial Hypertension

Objective: To study the relationship between the biomarker anti-NR2 associated with cerebral ischemia and neurocognitive mental status examination results in patients with essential hypertension (HTN) and those without it. Design and method: The study included 73 individuals with controlled essential HTN without associated clinical conditions. Mental status was assessed using the Mini-Mental State Examination (MMSE), with a cutoff for cognitive impairment (CI) set at < 28 points. The biomarker for cerebral ischemia, NR2-antibodies to NMDA receptors (anti-NR2) with a cutoff for cerebral ischemia defined as anti-NR2 level greater than or equal to 1.8 ng/ml. Results are expressed as median (Me) and percentiles [25%; 75%], and analyses were conducted using the Mann-Whitney test, Pearson Chi-square, or Fisher's exact tests. P values less than or equal to 0.05 were considered significant. Results: The first group comprised 45 patients with HTN, median age 57 [50;63] years, among whom 20 (44.4%) had CI. The second group included 28 individuals without HTN, median age 56 [47.5;58.5] years, among whom 10 (35.7%) had CI. Cerebral ischemia, defined by an anti-NR2 level greater than or equal to 1.8 ng/ml, was found in 23 (51.1%) and 8 (28.6%) individuals in the respective groups. In the HTN group, the median MMSE score was significantly lower (p=0.05) at 27 [26;28] compared to 28.5 [27;29] in the control group. Anti-NR2 levels were significantly higher (p=0.004) in the HTN group at 1.8 [1.37;2.72] ng/ml compared to 1.2 [0.95;1.92] ng/ml in the second group. Statistically significant differences were observed (p=0.05) in the frequency of cerebral ischemia based on HTN presence. The odds of developing cerebral ischemia were 2.6 times higher among patients with HTN (OR 2.61; 95% CI 0.96-7.15). Conclusions: Our study indicates that even in patients with controlled essential HTN, there is a gradual decline in cognitive functions. The MMSE score was significantly lower among patients with HTN (p=0.05). The increase in anti-NR2, used to interpret cerebral ischemia, was significantly higher in the HTN group (p=0.004). Our data suggest that the odds of developing cerebral ischemia increased by 2.6 times (p=0.05).