Association of blood pressure with cognitive impairment in elderly hypertensive patients in China: A cross-sectional study

Aims To investigate the prevalence of cognitive impairment among elderly Chinese patients with hypertension and explore the relationship between blood pressure and cognitive impairment. Additionally, the study examined the characteristics of cognitive impairment in hypertensive patients and its impact on blood pressure control. Methods A cross-sectional study was conducted involving 23,271 subjects. Data collection involved questionnaires, physical examinations, and blood tests. AD8 questionnaire, MMSE questionnaire, and neurologist interview, was used to screen patients for cognitive disabilities. Risk factors and prevalence of cognitive impairment were compared between hypertensive and non-hypertensive groups. The prevalence of cognitive impairment at different blood pressure levels was analyzed within the hypertension group. Differences in MMSE scores across dimensions were compared between hypertensive and non-hypertensive groups. Results The hypertensive group exhibited additional risk factors for cognitive impairment and a higher prevalence of cognitive impairment. The prevalence of cognitive impairment among hypertensive patients followed a U-shaped curve with increasing blood pressure, with the lowest rate observed among patients with blood pressure in the range of 120-139/80-89 mmHg. Several dimensions of cognitive function were significantly diminished in individuals with hypertension. Patients with cognitive impairment demonstrated lower compliance with hypertension treatment and poorer blood pressure control. Conclusion Cognitive decline across multiple dimensions is typical among older Chinese patients with hypertension, and cognitive impairment has detrimental effects on blood pressure management. Maintaining blood pressure in the 120-139/80-89 mmHg range appears to be more favorable for preserving cognitive function in hypertensive patients.