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Updated: Jun 5, 2026
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Albuminuria and decline in cognitive function: The ONTARGET/TRANSCEND studies
Joshua I Barzilay1, Peggy Gao, Martin O'Donnell
1Kaiser Permanente of Georgia, Emory University School of Medicine, Atlanta, USA. Joshua.barzilay@kp.org
Archives of Internal Medicine
|January 26, 2011
Summary
Kidney microvascular disease, indicated by albuminuria, is linked to cognitive decline. Treatments targeting this pathway may help prevent or treat both conditions.
Area of Science:
- Nephrology
- Neurology
- Cardiovascular Medicine
Background:
- Kidney microvascular disease (albuminuria) and brain microvascular disease (cognitive decline) may share common origins.
- Understanding their concurrent development can guide clinical practice and therapeutic strategies.
Purpose of the Study:
- To investigate the association between albuminuria and cognitive decline.
- To explore the potential modifying role of renin-angiotensin system inhibitors in this relationship.
Main Methods:
- Analysis of 28,384 participants with vascular disease or diabetes mellitus.
- Assessment of albuminuria and cognitive function (Mini-Mental State Examination) at baseline and 5-year follow-up.
- Multivariable logistic regression to determine cross-sectional and prospective associations.
Main Results:
- Increased odds of reduced cognitive function (MMSE <24) were observed with both microalbuminuria and macroalbuminuria.
- Baseline albuminuria predicted cognitive decline over 5 years.
- New-onset albuminuria was associated with increased odds of cognitive decline.
- Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use was linked to lower odds of cognitive decline in macroalbuminuria.
Conclusions:
- Albuminuria and cognitive decline likely share a common microvascular pathogenesis.
- These findings support a unified approach to managing microvascular disease affecting both kidneys and brain.
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