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Endothelial Activation Is Associated With Cognitive Performance in Patients With Hypertension

Renske Uiterwijk1, Marjolein Huijts2, Julie Staals3

  • 1Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands; renske.uiterwijk@mumc.nl.

American Journal of Hypertension
|August 14, 2015
PubMed

Insights

Elevated endothelial activation markers are linked to poorer cognitive function in hypertensive patients three years later. This suggests endothelial dysfunction may contribute to cognitive decline in hypertension.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Biomarkers

Background:

  • Hypertension is a known risk factor for cognitive deficits and dementia.
  • Cerebral small vessel disease (cSVD) is a likely mechanism linking hypertension to brain damage.
  • Endothelial activation and inflammation are implicated in cSVD pathogenesis.

Purpose of the Study:

  • To investigate the association between compound scores of endothelial activation and inflammation markers and cognitive performance.
  • To assess cognitive performance three years after baseline measurements in patients with essential hypertension.

Main Methods:

  • Measured blood markers of endothelial activation (sVCAM-1, sICAM-1, sP-selectin, sE-selectin) and inflammation (neopterin, C-reactive protein, sICAM-1) at baseline.
  • Created compound scores for endothelial activation and inflammation using z-scores.
  • Assessed cSVD using brain MRI and cognitive performance via neuropsychological assessment after three years.

Main Results:

  • In 101 hypertensive patients, higher endothelial activation scores correlated with worse cognitive performance (B = -0.19, P = 0.014).
  • Inflammation scores did not show a significant association with cognitive performance (B = -0.09, P = 0.198).
  • These associations remained significant after adjusting for demographics and cSVD MRI markers.

Conclusions:

  • Overall endothelial activation is associated with cognitive performance in patients with essential hypertension.
  • Endothelial activation may play a role in the development of cognitive problems associated with hypertension.
Abstract

Keywords:
blood pressurecerebral small vessel diseasecognitionendothelial activationhypertensioninflammation.

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