Hypertension control and its relationship with cognitive impairment among adults aged 45 to 80 in China

Q: What are the key findings of this study?

Severe blood pressure was associated with an increased odds of cognitive impairment compared to normal blood pressure in middle-aged and older adults with hypertension.

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=9688). Intervention: Severe blood pressure (SBP ≥180 mmHg or DBP ≥110 mmHg) vs. Normal blood pressure (SBP <140 mmHg and DBP <90 mmHg). Primary outcome: Cognitive impairment (assessed via Mini-Cog scale) (OR 1.588, 95% CI 1.105-2.280).

Q: What does this research mean for the field?

Severe uncontrolled hypertension is independently associated with an increased risk of cognitive impairment in middle-aged and older adults, with risk displaying a linear relationship with diastolic blood pressure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Xin Li; Qian Wu; Xing Chen; Yanmin Tang; Beini Fei; Qi ﻿﻿Zhao; Jing Ding; Xin Wang

doi:10.1101/2023.10.20.23297342

October 22, 2023Open Access

Hypertension control and its relationship with cognitive impairment among adults aged 45 to 80 in China

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Key result

Severe blood pressure linked to ~59% higher odds of cognitive impairment in older adults.

OR 1.588
95% CI 1.105-2.280
n=9,688

Why the study?

The relationship between hypertension control and cognitive impairment in Chinese adults aged 45-80 years was not well characterized.

Does uncontrolled hypertension increase the risk of cognitive impairment in middle-aged and older adults?

Key Points

To examine the status of hypertension control and evaluate its association with cognitive impairment in Chinese adults aged 45 to 80 years.
Analyzed cross-sectional survey data collected between 2019 and 2021 from Shanghai and Guizhou, China (N=9,688 eligible participants).
Assessed associations between blood pressure parameters and cognitive impairment using unconditional logistic regression and restricted cubic splines.
Severe high blood pressure was positively associated with an increased risk of cognitive impairment, whereas mild and moderate blood pressure showed no statistically significant association.
Restricted cubic spline models demonstrated a U-shaped association between systolic blood pressure and cognitive impairment, alongside a linear positive correlation for diastolic blood pressure.

Study Design

Type

Cross-Sectional (n=9,688)

Multicenter

Yes

Structured PICO

Does uncontrolled hypertension increase the risk of cognitive impairment in middle-aged and older adults?

P

Population

9,688 Chinese adults aged 45 to 80 years with a history of hypertension, drawn from community settings to assess the relationship between blood pressure control and cognitive impairment.

E

Exposure

Uncontrolled hypertension (categorized as severe BP: SBP ≥180 mmHg or DBP ≥110 mmHg; moderate BP: SBP 160–179 mmHg or DBP 100–109 mmHg; mild BP: SBP 140–159 mmHg or DBP 90–99 mmHg)

C

Comparator

Normal blood pressure (SBP <140 mmHg and DBP <90 mmHg)

O

Outcome

Cognitive impairment assessed comprehensively by the mini-cognitive assessment (Mini-Cog)surrogate

Main Result

Odds Ratio: 1.588 (95% CI 1.105–2.28)

Severe uncontrolled hypertension and progressively elevated diastolic blood pressure are independently associated with an increased risk of cognitive impairment in middle-aged and older Chinese adults.

Limitations

The mini-cog scale used is a screening tool and cannot be used for a definitive diagnosis of cognitive impairment.
Hypertension history and medication use were self-reported, potentially introducing recall error.
The cross-sectional design precludes causal inference between blood pressure control and cognitive impairment.
The mini-cog scale used in this study is a screening scale, which only has a screening effect on cognitive function and cannot be diagnosed
This study only conducted a single test on the subjects of the study. The blood pressure measurement of the patients and the use of antihypertensive drugs and hypertension history are self-reported
This study is a cross-sectional study, measuring blood pressure and cognitive status at the same time, it is impossible to infer causality

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

No practice change warranted; leaves open whether BP control mitigates cognitive risk in middle-aged hypertensive adults.

Abstract

This cross-sectional study aimed to investigate the control of hypertension and its association with cognitive impairment in Chinese adults aged 45-80 years. Using cross-sectional surveys conducted in Shanghai and Guizhou from 2019-2021, 9,688 eligible subjects were eventually included. After analyzing the data using statistical methods such as unconditional logistic regression and restricted cubic splines (RCS), we found that severe blood pressure was positively associated with the risk of cognitive impairment. There was no significant association between mild/moderate BP and the risk of cognitive impairment. Moreover, diastolic blood pressure was significantly positively correlated with cognitive impairment. The restricted cubic spline modelresults showed that the associations with cognitive impairment seem to be U-shaped for SBP and linear for DBP. In conclusion, this study shows that uncontrolled hypertension is an independent risk factor for cognitive impairment and that the risk of cognitive impairment increases as diastolic blood pressures continues to rise.

Discussion

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Cite This Study

Li et al. (2023) conducted a cross-sectional in Hypertension (n=9,688). Severe blood pressure (SBP ≥180 mmHg or DBP ≥110 mmHg) vs. Normal blood pressure (SBP <140 mmHg and DBP <90 mmHg) was evaluated on Cognitive impairment (assessed via Mini-Cog scale) (OR 1.588, 95% CI 1.105-2.280). Severe blood pressure was associated with an increased odds of cognitive impairment compared to normal blood pressure in middle-aged and older adults with hypertension.

synapsesocial.com/papers/6ac9c926588f84dcb78a4a19 https://doi.org/10.1101/2023.10.20.23297342

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Hypertension control and its relationship with cognitive impairment among adults aged 45 to 80 in China

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Hypertension control and its relationship with cognitive impairment among adults aged 45 to 80 in China

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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