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Published on: September 25, 2017
Left ventricular hypertrophy and cognitive function: a systematic review
C Restrepo1, S K Patel1,2, V Rethnam1
1The Florey Institute of Neuroscience and Mental Health, Austin Health, Heidelberg, VIC, Australia.
Insights
Left ventricular hypertrophy (LVH), a marker of hypertension damage, is linked to cognitive impairment. This review found LVH is associated with poorer memory and executive functions in adults over 50.
Area of Science:
- Cardiology
- Neurology
- Gerontology
Background:
- Cognitive impairment frequently affects patients with hypertension.
- Left ventricular hypertrophy (LVH) signifies hypertension-related organ damage and predicts cardiovascular events.
- Existing evidence suggests LVH independently correlates with cognitive decline, even accounting for hypertension.
Purpose of the Study:
- To systematically review studies investigating cognitive impairment in adults with LVH.
- To identify specific cognitive domains affected by LVH.
- To explore potential mechanisms linking LVH and cognitive dysfunction.
Main Methods:
- Systematic literature search in Ovid MEDLINE, Ovid psycInfo, and PubMed.
- Inclusion criteria: English language, human studies, adults aged 50+, examining LVH and cognition.
- Nine studies met the criteria for inclusion in the review.
Main Results:
- The majority of included studies demonstrated an association between LVH and cognitive performance.
- Individuals with LVH generally showed lower performance on cognitive tests compared to those without LVH.
- Memory and executive functions were identified as cognitive domains particularly vulnerable to the presence of LVH.
Conclusions:
- LVH is associated with impaired cognitive performance, specifically affecting memory and executive functions.
- Cerebral white matter damage, common in LVH patients, may underlie the observed cognitive dysfunction.
- These findings highlight the impact of LVH on cognitive health, particularly in older adults.
Abstract:
Cognitive impairment is common in patients with hypertension. Left ventricular hypertrophy (LVH) is recognised as a marker of hypertension-related organ damage and is a strong predictor of coronary artery disease, heart failure and stroke. There is evidence that LVH is independently associated with cognitive impairment, even after adjustment for the presence of hypertension. We conducted a systematic review that examined cognitive impairment in adults with LVH. Independent searches were performed in Ovid MEDLINE, Ovid psycInfo and PubMed with the terms left ventricular hypertrophy and cognition. Seventy-three studies were identified when both searches were combined. After limiting the search to studies that were: (1) reported in English; (2) conducted in humans; (3) in adults aged 50 years and older; and (4) investigated the relationship between LVH and cognitive performance, nine papers were included in this systematic review. The majority of studies found an association between LVH and cognitive performance. Inspection of results indicated that individuals with LVH exhibited a lower performance in cognitive tests, when compared to individuals without LVH. Memory and executive functions were the cognitive domains that showed a specific vulnerability to the presence of LVH. A possible mechanism for the relationship between LVH and cognition is the presence of cerebral white matter damage. White matter lesions occur frequently in patients with LVH and may contribute to cognitive dysfunction. Together, the results of this review suggest that memory impairment and executive dysfunction are the cognitive domains that showed a particular association with the presence of LVH.
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