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Updated: Feb 15, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Impact of hypertension severity on arterial stiffness, cerebral vasoreactivity, and cognitive performance
Henrique Cotchi Simbo Muela1,2, Valeria A Costa-Hong1, Monica Sanches Yassuda3
1Heart Institute (Incor), University of São Paulo Medical School - Hypertension Unit São Paulo, São Paulo, SP, Brazil.
Abstract:
Aging, hypertension (HTN), and other cardiovascular risk factors contribute to structural and functional changes of the arterial wall.
Objective:
To evaluate whether arterial stiffness (AS) is related to cerebral blood flow changes and its association with cognitive function in patients with hypertension.
Methods:
211 patients (69 normotensive and 142 hypertensive) were included. Patients with hypertension were divided into 2 stages: HTN stage-1 and HTN stage-2. The mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA) and a battery of neuropsychological (NPE) tests were used to determine cognitive function. Pulse wave velocity was measured using the Complior®. Carotid properties were assessed by radiofrequency ultrasound. Central arterial pressure and augmentation index were obtained using applanation tonometry. Middle cerebral artery flow velocity was measured by transcranial Doppler ultrasonography.
Results:
Both arterial stiffness parameters and cerebral vasoreactivity worsened in line with HTN severity. There was a negative correlation between breath holding index (BHI) and arterial stiffness parameters. Cognitive performance worsened in line with HTN severity, with statistical difference occurring mainly between the HTN-2 and normotension groups on both the MMSE and MoCA. The same tendency was observed on the NPE tests.
Conclusion:
Hypertension severity was associated with higher AS, worse BHI, and lower cognitive performance.
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