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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Hypertensive organ damage predicts future cognitive performance: A 9-year follow-up study in patients with

Renske Uiterwijk1,2, Julie Staals1,3, Marjolein Huijts4

  • 1Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands.

Journal of Clinical Hypertension (Greenwich, Conn.)
|October 3, 2018
PubMed

Insights

Hypertension can harm cognition. Cardiac damage, indicated by left ventricular mass index (LVMI), predicts future cognitive decline, even independently of brain damage in hypertensive patients.

Area of Science:

  • Cardiology
  • Neurology
  • Nephrology

Background:

  • Hypertension is linked to cognitive deficits, often attributed to cerebral small vessel disease.
  • The impact of additional cardiac and renal damage on cognitive decline in hypertensive individuals is less understood.

Purpose of the Study:

  • To investigate the association between cardiac and renal organ damage, and their combined presence, with future cognitive performance in patients with essential hypertension.

Main Methods:

  • Seventy-eight hypertensive patients underwent assessment of brain damage via MRI, cardiac damage via left ventricular mass index (LVMI), and renal damage via estimated glomerular filtration rate (eGFR) and albuminuria.
  • Neuropsychological assessments were conducted at a 9-year follow-up.

Main Results:

  • Higher LVMI was significantly associated with lower future cognitive performance (P=0.032), independent of other factors.
  • Renal function (eGFR and albuminuria) did not show a significant association with future cognition.
  • The presence of two or three types of organ damage correlated with poorer cognitive outcomes compared to none.

Conclusions:

  • Cardiac damage, specifically elevated LVMI, is an independent predictor of cognitive decline in hypertension.
  • The cumulative burden of hypertensive organ damage, particularly cardiac involvement, may identify patients at higher risk for cognitive impairment.

Keywords:
cardiac damagecerebral small vessel diseasecognitionhypertensionrenal damage

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