NR2-antibodies and cognitive impairment in patients with controlled hypertension

Aim . To investigate the relationship between cognitive impairment (CI) and serum NR2 antibody (NR2-AB) levels in patients with controlled hypertension (HTN) of stage I-II. Material and methods. A single-centre study included 105 patients (75 with essential HTN and 30 controls) aged 40–70 years. Serum NR2-AB levels were measured by enzyme-linked immunosorbent assay (ELISA), with a threshold of 1.8 ng/mL. Cognitive status was assessed using the Montreal Cognitive Assessment (MoCA): normal ≥26 points, CI ≤25 points. All patients with HTN received combination antihypertensive therapy and had achieved target blood pressure levels at inclusion. Results . NR2-AB levels were significantly higher in HTN patients (2.93 [1.46; 4.13] ng/mL) than in controls (1.35 [1.02; 2.09] ng/mL; p=0.001). CI was detected 8 times more frequently in HTN patients compared with controls (52% vs 6.7%). A negative correlation was observed between NR2-AB levels and MoCA scores (r= 0.2; p=0.048). Furthermore, a significant association between the marker and the presence of cognitive impairment was found in the univariate regression analysis (odds ratio=1.21; 95% confidence interval: 1.027-1.42; p=0.022), suggesting that this neuronal injury marker is linked to cognitive decline. ROC analysis revealed that an NR2-AB cutoff of 1.73 ng/mL had discriminative capacity for CI (sensitivity 71%, specificity 50%). In the multivariable logistic regression analysis, age, body mass index, and the presence of HTN were significantly associated with CI; the association with NR2-AB levels was not statistically significant (p=0.143). Conclusion . In patients with controlled stage I-II HTN, serum NR2AB levels are significantly elevated even after achieving target blood pressure. Age, body mass index, and HTN were significantly associated with CI.