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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

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Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension

Ying Xu1,2, George Bouliotis3, Nigel S Beckett4

  • 1Neuroscience Research Australia, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia. y.xu@neura.edu.au.

Journal of Human Hypertension
|April 2, 2022
PubMed

Insights

Left ventricular hypertrophy (LVH), a marker of high blood pressure damage, was linked to cognitive decline in older adults. However, the association varied by electrocardiogram (ECG) criteria, and LVH did not predict dementia.

Area of Science:

  • Cardiology
  • Neurology
  • Gerontology

Background:

  • Hypertension is a known risk factor for cognitive decline.
  • Left ventricular hypertrophy (LVH), a sign of hypertensive target organ damage, may help identify individuals at risk.
  • Understanding the link between LVH and cognitive decline in the elderly is crucial.

Purpose of the Study:

  • To investigate the association between LVH and subsequent cognitive decline or dementia in hypertensive individuals aged 80 years and older.
  • To determine if different electrocardiogram (ECG) criteria for LVH yield consistent results regarding cognitive outcomes.

Main Methods:

  • Utilized data from the Hypertension in the Very Elderly Trial (Hypertension in the Very Elderly Trial), a randomized, placebo-controlled study.
  • Assessed LVH using 12-lead ECG with Cornell Product (CP-LVH), Sokolow-Lyon (SL-LVH), and Cornell Voltage (CV-LVH) criteria.
  • Monitored cognitive function using the Mini-Mental State Examination (MMSE) and analyzed data with Fine-Gray regression models, accounting for death as a competing event.

Main Results:

  • Cornell Product-LVH (CP-LVH) was associated with an increased risk of cognitive decline (sHR 1.3; 95% CI 1.01-1.67).
  • Sokolow-Lyon-LVH (SL-LVH) and Cornell Voltage-LVH (CV-LVH) did not show a significant association with cognitive decline.
  • No significant association was found between any LVH criterion and the incidence of dementia.

Conclusions:

  • LVH may be associated with subsequent cognitive decline in elderly hypertensive patients, but the relationship is inconsistent and depends on the ECG criterion used.
  • LVH assessment via ECG did not predict incident dementia in this population.
  • Further research is needed to clarify the complex interplay between blood pressure, LVH assessment methods, and cognitive trajectories.

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