Risk factors for cognitive impairment in arterial hypertension | Український Медичний Часопис

The results of the neuropsychological examination of 509 outpatients with controlled second-stage arterial hypertension (AG) with an integral assessment of cognitive functions using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MоCA) techniques are presented in the article. It has been established that even in patients with a controlled second-stage AG with a low cardiovascular risk of SCORE scalе (32.2%) show non-dementia cognitive impairment. The risk factors for the development of cognitive impairment in AG, in connection with the features of anamnesis and the course of the disease, were analyzed. It has been proved that the risk factors for the development of cognitive impairment due to AG are burdened with heredity regarding cognitive impairment in the immediate family, the long-term course of the disease (about 10 years), signs of an unbalance in the autonomic nervous system: high vegetative index, the systolic blood pressure variability over the day according to the daily monitoring blood pressure higher than 12 mm Hg (area under the ROC curve AUC=0.891 (95% confidence interval 0.823–0.940) with sensitivity 82.5% and specificity 85.7%, with the probability of cognitive impairment exceeding 50%, which is a high risk).

Published: 12.04.2019

References:

Vsemirnaya organizatsiya zdravoohraneniya (2013) Globalnoe rezyume po gipertonii (https://apps.who.int/iris/bitstream/handle/10665/79059/WHO_DCO_WHD_2013.2_rus.pdf;jsessionid=A76836BF5894ED845C9EC20EF403F200?sequence=5).
Mischenko T.S., Mischenko V.N. (2011) Sosudistaya dementsiya. NeyroNews, 2(1): 32–34.
MOZ Ukrainy (2012) Nakaz MOZ Ukrainy vid 24.05.2012 r. № 384 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry arterialnii hipertenzii» (https://zakon.rada.gov.ua/rada/show/v0384282-12).
Altman D.G. (1991) Practical Statistics for Medical Research. Chapman and Hall, London, 624 p.
Coca A. (Ed.) (2016) Hypertension and Brain Damage (Updates in Hypertension and cardiovascular Protection). Springer, 211 p.
Bland M. (2010) An Introduction to Medical Statistics (Oxford Medical Publications). Oxford University Press, 405 p.
Borson S., Scanlan J.M., Watanabe J. et al. (2005) Simplifying detection of cognitive impairment: comparison of the Mini-Cog and Mini-Mental State Examination in a multiethnic sample. J. Am. Geriatr. Soc., 53(5): 871–874.
George Institute for Global Health (2016) High blood pressure linked to vascular dementia (http://www.sciencedaily.com/releases/2016/05/160518120124.htm).
Iadecola C., Yaffe K., Biller J. et al.; American Heart Association Council on Hypertension, Council on Clinical Cardiology, Council on Cardiovascular Disease in the Young, Council on Cardiovascular and Stroke Nursing, Council on Quality of Care and Outcomes Research, Stroke Council (2016) Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association. Hypertension, 68(6): e67–e94.
Mancia G., Fagard R., Narkiewicz K. et al. (2013) 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur. Heart J., 34(28): 2159–2219.
Williams B., Mancia G., Spiering W. et al.; ESC Scientific Document Group (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur. Heart J., 39(33): 3021–3104.