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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Published on: April 23, 2021

White matter hyperintensities and medication adherence.

Kathleen C Insel1, Sheryl L Reminger, Chao-Pin Hsiao

  • 1College of Nursing, University of Arizona, Tucson, AZ 85721, USA. insel@nursing.arizona.edu

Biological Research for Nursing
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Summary

White matter hyperintensities (WMH), linked to hypertension, may impact medication adherence. This study explored the connection between brain changes, cognitive function, and adherence in hypertensive patients.

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Area of Science:

  • Neurology
  • Gerontology
  • Cardiology

Background:

  • White matter hyperintensities (WMH) are common in aging and hypertension.
  • Previous research links WMH to cognitive decline.
  • The relationship between WMH and medication adherence is understudied.

Purpose of the Study:

  • To investigate the association between WMH and medication adherence in hypertensive individuals.
  • To explore the role of cognitive function in this relationship.
  • To understand hypertension's impact on self-management.

Main Methods:

  • 16 middle-aged and older adults with hypertension were studied.
  • Magnetic resonance imaging (MRI) assessed WMH.
  • Cognitive tests measured executive function, memory, and attention.
  • Electronic monitoring tracked medication adherence for 8 weeks.

Main Results:

  • More WMH correlated with poorer medication adherence (rs = -0.25) and higher systolic blood pressure (rs = 0.46), though not statistically significant.
  • WMH showed expected associations with cognitive tests (e.g., Digit Span Backward, rs = -0.53, p < .05).
  • Adherence linked to immediate memory (rs = 0.54, p < .05) and Wisconsin Card Sorting Test performance (rs = -0.61, p < .05).

Conclusions:

  • Preliminary evidence suggests WMH are associated with cognitive function and medication adherence.
  • Hypertension-related brain changes may influence self-management behaviors.
  • Further research is needed to confirm these associations.