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Serum Bicarbonate Concentration and Cognitive Function in Hypertensive Adults
Mirela Dobre1, Sarah A Gaussoin, Jeffrey T Bates
1Due to the number of contributing authors, the affiliations are provided in the Supplemental Material .
Summary
Higher serum bicarbonate levels correlate with better cognitive function in hypertensive adults. This suggests metabolic acidosis may impact brain health, highlighting a potential area for intervention in chronic kidney disease.
Area of Science:
- Nephrology
- Neurology
- Metabolic Disorders
Background:
- Cognitive decline is linked to reduced kidney function, but underlying mechanisms remain unclear.
- Metabolic acidosis, a common chronic kidney disease (CKD) complication, may affect neural activity and cerebral blood flow regulation.
- Understanding the link between metabolic acidosis and cognition is crucial for managing CKD patients.
Purpose of the Study:
- To investigate the association between serum bicarbonate levels, a marker for metabolic acidosis, and cognitive function in hypertensive adults.
- To explore this relationship in individuals with and without CKD.
Main Methods:
- Analysis of 2853 participants from the Systolic BP Intervention Trial (SPRINT).
- Cognitive function assessed using five summary scores: global, executive, memory, attention/concentration, and language.
- Multivariable regression models adjusted for demographics, comorbidities, blood pressure, medications, and kidney function markers (eGFR, albuminuria).
- Brain MRI data from a subset (n=681) were used for further adjustments.
Main Results:
- Higher serum bicarbonate levels were positively associated with better global cognitive function (P=0.01) and executive function (P=0.003).
- Each 1 mEq/L decrease in bicarbonate was equivalent to 4.3 months of aging for global cognition and 5.4 months for executive function.
- These associations remained significant after adjusting for brain imaging findings.
- No significant association was found between bicarbonate levels and memory, attention/concentration, or language.
Conclusions:
- In hypertensive adults, elevated serum bicarbonate is independently linked to enhanced global and executive cognitive performance.
- This finding suggests that managing metabolic acidosis may be important for preserving cognitive function in individuals with CKD.
- Further research is warranted to elucidate the precise mechanisms and clinical implications.
Keywords:
AdultAttentionBicarbonateBicarbonatesCerebrovascular CirculationCognitionCohort StudiesComorbidityCross-Sectional StudiesDemographyExecutive FunctionHomeostasisHumansLanguageLinear ModelsMagnetic Resonance ImagingMemoryRenal Insufficiency, ChronicWhite Matteracidosisalbuminuriablood pressurechronic kidney diseasecognitive function
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