Trajectories of memory function before and after cardiovascular disease among hypertensive patients

The trajectories of cognitive function before and after cardiovascular disease (CVD) have been widely explored in the general population, but less is known in hypertensive patients who are regarded as the most vulnerable patients for both CVD and dementia. The cohort study was conducted on hypertensive patients with no history of CVD at baseline from the Health and Retirement Study (HRS) 2006–2021, including 6038 participants. During the follow-up, 2101 incident CVD (683 incident stroke and 1727 incident heart disease) were identified. The memory function was assessed at each wave. Linear mixed-effects models were used to estimate the temporal changes in memory function before and after CVD onset among hypertensive patients. Compared with hypertensive patients who remained CVD-free, hypertensive patients who later experienced incident CVD during follow-up had accelerated memory decline before CVD onset (-0.018 SD/year; 95% CI: -0.024, -0.012). We additionally found an acute memory decline during CVD onset (-0.131 SD/year; 95% CI: -0.167, -0.096) among hypertensive patients. The annual post-CVD rates of memory decline were similar to the pre-CVD decline rates (-0.001 SD/years; 95% CI: -0.008, 0.007) among hypertensive patients. We found similar results in the subtypes of CVD, that both incident stroke or heart disease were associated with accelerated memory decline before, and immediately during, but not after stroke or heart disease incidence. Among hypertensive patients, we found incident CVD was associated with accelerated memory decline before and immediately during, but not after CVD onset. Our results highlighted that early intervention of hypertensive patients with rapid memory function decline may be important for the prevention of CVD and dementia.