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Updated: Aug 31, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Periventricular rather than deep white matter hyperintensities mediate effects of hypertension on cognitive

Janine Gronewold1, Martha Jokisch1, Sara Schramm2

  • 1Department of Neurology, University Hospital Essen.

Journal of Hypertension
|August 19, 2022
PubMed
Abstract

Insights

Periventricular hyperintensities (PVH) significantly mediate the negative impact of high blood pressure on cognitive function, particularly affecting nonverbal memory and executive functions in older adults.

Area of Science:

  • Neurology
  • Cardiology
  • Gerontology

Background:

  • White matter hyperintensities (WMH) are common in older adults and linked to small vessel disease and hypertension.
  • WMH are associated with cognitive deficits, but the interplay between blood pressure, WMH, and cognition needs further study.

Purpose of the Study:

  • To investigate the interdependence of systolic blood pressure (SBP), diastolic blood pressure (DBP), antihypertensive medications, WMH, and cognitive performance.
  • To determine the mediating role of different types of WMH in the relationship between blood pressure and cognition.

Main Methods:

  • Analysis of 560 participants from the population-based 1000BRAINS study.
  • Assessment of blood pressure, antihypertensive treatment, WMH (PVH and DWMH), and cognitive performance.

Main Results:

  • Blood pressure and its treatment were moderately associated with cognitive performance.
  • Periventricular hyperintensities (PVH) strongly mediated the effect of SBP on global cognition (52%), while deep white matter hyperintensities (DWMH) mediated less (16%).
  • PVH showed the strongest mediation for SBP's effects on nonverbal memory (94%) and executive function (81%).

Conclusions:

  • PVH may predispose individuals to cognitive impairment linked to hypertension.
  • The findings highlight the critical role of PVH in mediating the cognitive effects of hypertension, especially in nonverbal memory and executive functions.

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