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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

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Association of cognitive dysfunction with cardiovascular disease events in elderly hypertensive patients

Yuichiro Yano1, George L Bakris, Takashi Inokuchi

  • 1aAmerican Society of Hypertension Comprehensive Hypertension Center, Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Chicago Medicine, Chicago, Illinois, USA bDivision of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi cDepartment of Orthopedics, Chikamorikai Medical Group, Kochi dTamaki Clinic eKijo Clinic fKuwabara Clinic gYokota Naika hEto Cardiology Clinic iKuroki Naika, Miyazaki, Japan.

Journal of Hypertension
|December 20, 2013
PubMed

Insights

Cognitive dysfunction independently predicts cardiovascular disease (CVD) events in elderly hypertensive patients. Early detection of cognitive impairment may aid in CVD risk assessment.

Area of Science:

  • Cardiology
  • Neurology
  • Geriatrics

Background:

  • Hypertension is a major risk factor for cardiovascular disease (CVD).
  • Cognitive dysfunction is common in elderly populations and may be linked to vascular health.
  • The independent role of cognitive dysfunction in predicting CVD events in hypertensive patients requires further investigation.

Purpose of the Study:

  • To determine if cognitive dysfunction is an independent marker for cardiovascular disease (CVD) events in elderly hypertensive patients.
  • To assess the association of cognitive dysfunction with CVD events, independent of ambulatory blood pressure (BP) and target organ damage (TOD).

Main Methods:

  • 585 hypertensive patients (mean age 73) without dementia were recruited.
  • Cognitive function assessed using Mini-Mental State Examination (MMSE); cognitive dysfunction defined as lowest MMSE quartile.
  • Cardiovascular disease events (coronary artery disease, stroke, heart failure, sudden death) were prospectively ascertained over 2.8 years.

Main Results:

  • Cognitive dysfunction was more prevalent in patients who experienced CVD events (57% vs. 29%).
  • Cognitive dysfunction was independently associated with a 2.5-2.9 fold increased risk of CVD events, even after adjusting for BP and TOD.
  • Including MMSE scores in risk models significantly improved CVD event prediction.

Conclusions:

  • Cognitive dysfunction serves as an independent predictor of increased cardiovascular disease risk in elderly hypertensive individuals.
  • Cognitive impairment may represent an early marker for cardiovascular events in this population.
  • Assessing cognitive function can enhance cardiovascular risk stratification in hypertensive patients.
Abstract

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