Cognitive dysfunction and hypertension: literature review and own experience

May 16, 2019
1219
Resume

The article summarizes available data linking arterial hypertension (AG) to cognitive dysfunction, dementia. In own study we also found that AG significantly increases the incidence of cognitive dysfunction in middle-aged persons (49.8±9.0 years). We selected 59 patients with AG of 2–3 degrees (the average level of systolic and diastolic blood pressure 166±13 and 97±6 mm Hg, respectively) (1st group) and 30 practically healthy individuals with normal level of blood pressure (2nd group). Neuropsychological examination was carried out by General Practitioner Assessment of Cognition (GPCOG), Mini-Mental State Examination (MMSE) and Schulte table. Significant cognitive decline was found in patients in the 1st group (MMSE 26.6±1.8, GPCOG 6.9±1.4, Schulte’s test 52.3±10.7; p<0.05). Such results correspond to mild and mode­rate cognitive dysfunction. There was no cognitive dysfunction in the 2nd group (MMSE 28.9±1.0, GPCOG 8.3±1.4, Schulte’s test 33.4±4.2).

DOI 10.32471/umj.1680-3051.131.142189

Published: 16.05.2019

References:

  • Anderson C., Teo K., Gao P. et al. (2011) Renin-angiotensin system blockade and cognitive function in patients at high risk of cardiovascular disease: analysis of data from the ONTARGET and TRANSCEND studies. Lancet Neurol., 10(1): 43–53.
  • Fogari R., Mugellini A., Zoppi A. et al. (2004) Effects of valsartan compared with enalapril on blood pressure and cognitive function in elderly patients with essential hypertension. Eur. J. Clin. Pharmacol., 59: 863–868.
  • Forette F., Seux M.L., Staessen J.A. et al. (2002) Systolic hypertension in Europe investigators. The prevention of dementia with antihypertensive treatment: new evidence from the systolic hypertension in Europe (Syst. Eur.) study. Arch. Intern. Med., 162(18): 2046–2052.
  • Hajjar I., Hart M., Chen Y.L. et al. (2002) Effect of antihypertensive therapy on cognitive function in early executive cognitive impairment: a double-blind randomized clinical trial. Arch. Intern. Med., 172(5): 442–444.
  • Hanon O., Berrou J.P., Negre-Pages L. et al. (2008) Effects of hypertension therapy based on eprosartan on systolic arterial blood pressure and cognitive function: primary results of the Observational Study on Cognitive function And Systolic Blood Pressure Reduction open-label study. J. Hypertens., 26(8): 1642–1650.
  • Kearney-Schwartz A., Rossignol P., Bracard S. et al. (2009) Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints. Stroke, 40: 1229–1236.
  • Kilander L., Nyman H., Boberg M. et al. (1998) Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension, 31: 780–786.
  • Larrieu S., Letenneur L., Orgogozo J.M. (2002) Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology, 59: 594–599.
  • Launer L.J., Ross G.W., Petrovitch H. et al. (2000) Midlife blood pressure and dementia: the Honolulu-Asia aging study. Neurobiol Aging., 21: 49–55.
  • Levi Marpillat N., Macquin-Mavier I., Tropeano A.I. et al. (2013) Antihypertensive classes, cognitive decline and incidence of dementia: a network meta-analysis. J. Hypertens., 31(6): 1073–1082.
  • Mahoney J.R., Verghese J., Goldin Y. et al. (2010) Alerting, orienting, and executive attention in older adults. J. Int. Neuropsychol. Soc., 16(5): 877–889.
  • McGuinness B., Todd S., Passmore P., Bullock R. (2009) Blood pressure lowering in patients without prior cerebrovascular disease for prevention of cognitive impairment and dementia. Cochrane Database of Systematic Reviews, 4.
  • Ninomiya T., Ohara T., Hirakawa Y. et al. (2011) Midlife and late-life blood pressure and dementia in Japanese elderly: the Hisayama study. Hypertension, 58(1): 22–28.
  • Richmond R., Law J., Kay-Lambkin F. (2011) Higher blood pressure associated with higher cognition and functionality among centenarians in Australia. Am. J. Hypertens., 24(3): 299–303.
  • Shehab A., Abdulle A. (2011) Cognitive and autonomic dysfunction measures in normal controls, white coat and borderline hypertension. BMC Cardiovasc. Disord., 11.
  • Swan G.E., Carmelli D., La Rue A. (1996) Relationship between blood pressure during middle age and cognitive impairment in old age: The Western Collaborative Group Study. Aging Neuropsychol. Сognit., 3: 241–250.
  • Tzourio C., Dufouil C., Ducimetiere P. et al. (1999) Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. EVA Study Group. Epidemiol. Vasc. Aging Neurol., 53: 1948–1952.
  • Weidung B., Littbrand H., Nordström P. et al. (2016) The association between SBP and mortality risk differs with level of cognitive function in very old individuals. J. Hypertens., 34(4): 745–752.
  • WHO (2017) Dementia: fact sheet (https://www.who.int/news-room/fact-sheets/detail/dementia).
  • Williams B., Mancia G., Spiering W. et al. (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension (https://academic.oup.com/eurheartj/article/39/33/3021/5079119).
  • Yasar S., Ko J.Y., Nothelle S. et al. (2011) Evaluation of the effect of systolic blood pressure and pulse pressure on cognitive function: the Women’s Health and Aging Study II. PLOS One, 6(12) (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0027976).