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Hypertension and Risk of Post-Operative Cognitive Dysfunction (POCD): A Systematic Review and Meta-Analysis

I Feinkohl1, G Winterer2, T Pischon1,2,3

  • 1Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.

Clinical Practice and Epidemiology in Mental Health : CP & EMH
|June 13, 2017
PubMed

Insights

Hypertension does not appear to increase the risk of post-operative cognitive dysfunction (POCD). However, further research is needed due to study limitations, particularly in male populations.

Area of Science:

  • Medical research
  • Clinical epidemiology
  • Nephrology

Background:

  • Post-operative cognitive dysfunction (POCD) is common after major surgery.
  • Hypertension is a known risk factor for age-related cognitive decline.
  • The link between hypertension and POCD risk remains unclear.

Purpose of the Study:

  • To systematically review and meta-analyze the available evidence on hypertension as a risk factor for POCD.
  • To evaluate the association between hypertension and the incidence of POCD.

Main Methods:

  • Systematic literature search of PubMed, Ovid SP, and Cochrane Database.
  • Inclusion of longitudinal studies reporting hypertension and POCD outcomes.
  • Meta-analysis of relative risks or odds ratios using fixed-effects models.

Main Results:

  • Twenty-four studies involving 4317 patients were analyzed.
  • Overall, hypertension was not significantly associated with POCD risk (RR 1.01, p=0.82).
  • A significant association was found in studies with >75% males, showing a 27% increased POCD risk (RR 1.27, p=0.005).

Conclusions:

  • Current evidence does not support hypertension as a general risk factor for POCD.
  • Limitations include non-hypothesis-driven studies and lack of confounder adjustment.
  • Further systematic investigations are warranted to clarify hypertension's role in POCD epidemiology.
Abstract

Keywords:
Blood pressureCognitive epidemiologyHypertensionMeta-AnalysisPOCDPost-operative cognitive dysfunction

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