Key result
High NLR and reduced SDNN linked to ~184% greater cognitive impairment risk in hypertensive patients.
Why the study?
Hypertension is a significant risk factor for cognitive decline, but the roles of systemic inflammation and autonomic dysfunction in this progression remain poorly understood.
Are elevated neutrophil-to-lymphocyte ratio and reduced heart rate variability associated with cognitive impairment in hypertensive patients?
Cross-Sectional (n=161)
No
Are elevated neutrophil-to-lymphocyte ratio and reduced heart rate variability associated with cognitive impairment in hypertensive patients?
Elevated systemic inflammation (NLR) and reduced autonomic flexibility (SDNN) are independent predictors of cognitive decline in hypertensive patients.
Answers are grounded in this paper and cite their sources.
NLR >2.5 and SDNN <30 ms associate with cognitive impairment in hypertension; leaves open causality and need for prospective validation.
Background: Hypertension is a significant risk factor for cognitive decline, yet the roles of systemic inflammation and autonomic dysfunction in this progression remain poorly understood. This study aimed to evaluate the associations between the neutrophil-to-lymphocyte ratio (NLR), heart rate variability (HRV), and cognitive impairment in hypertensive patients. Methods: A cross-sectional study was conducted among 161 subjects (88 hypertensive and 73 normotensive). Cognitive function was assessed using the Hindi mini-mental state examination and the Hindi Montreal Cognitive Assessment (MoCA). Autonomic function was measured via HRV parameters, including standard deviation of normal to normal intervals (SDNN) and low-frequency power. Systemic inflammation was evaluated using the NLR. Independent predictors were identified using multivariate regression analysis. Results: Hypertensive subjects demonstrated significantly lower cognitive scores (MoCA: 24.89 ± 2.67 vs. 26.90 ± 1.78; P < 0.001) and higher NLR (2.89 ± 1.18 vs. 1.01 ± 0.24; P = 0.034) compared to normotensives. Within the hypertensive group, 19.3% exhibited cognitive impairment. These individuals had significantly higher NLR (3.01 ± 0.78 vs. 2.23 ± 0.49; P = 0.02) and lower SDNN (31.78 ± 19.38 vs. 36.12 ± 22.81 ms; P = 0.023). Multivariate analysis identified age (β = −0.312), elevated systolic blood pressure (SBP) (β = −0.245), NLR (β = −0.198), and SDNN (β = 0.186) as independent predictors of cognitive status. Adjusting for confounders, the risk of cognitive impairment was 4.12 times higher with SBP > 140 mmHg ( P < 0.001), 2.84 times higher with NLR >2.5 ( P = 0.003), and 2.31 times higher with SDNN <30 ms ( P = 0.014). Conclusion: Elevated systemic inflammation (NLR) and reduced autonomic flexibility (SDNN) are independent predictors of cognitive decline in hypertensive patients. These markers, alongside SBP, provide critical prognostic value for identifying patients at high risk of cognitive impairment.
No takes yet. Share an insight, caveat, or question.
Khan et al. (2026) conducted a cross-sectional in Hypertension (n=161). Elevated neutrophil-to-lymphocyte ratio (NLR >2.5) vs. NLR ≤2.5 was evaluated on Cognitive impairment (OR 2.84, p=0.003). Elevated systemic inflammation (NLR >2.5) and reduced autonomic flexibility (SDNN <30 ms) were associated with a 2.84-fold and 2.31-fold higher risk of cognitive impairment in hypertensive patients.
Synapse has enriched 10 related papers. Consider them for comparative context: