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Updated: Aug 23, 2025

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

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Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and

Timothy M Hughes1, Samuel N Lockhart1, Cynthia K Suerken2

  • 1Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.

Journal of Alzheimer'S Disease : JAD
|October 31, 2022
PubMed

Insights

Hypertension and impaired glucose tolerance significantly impact cognitive function and brain health in older adults. Their combined effect exacerbates white matter damage and reduces brain blood flow, increasing Alzheimer's disease risk.

Area of Science:

  • Neurology
  • Cardiology
  • Gerontology

Background:

  • Cardiometabolic disorders like hypertension and diabetes are significant risk factors for Alzheimer's disease.
  • The independent effects of these conditions on brain structure and function remain unclear.

Purpose of the Study:

  • To investigate the combined impact of hypertension and impaired glucose tolerance on cognitive function and neuroimaging biomarkers.
  • To assess associations with white matter health and cerebral perfusion in a diverse cohort of older adults.

Main Methods:

  • Utilized clinical evaluation, oral glucose tolerance testing, and advanced neuroimaging (T1, FLAIR, ASL, DTI, NODDI).
  • Categorized participants based on hypertension and impaired glucose tolerance status.
  • Employed multivariable linear regression to model associations with cognitive and neuroimaging outcomes.

Main Results:

  • Combined hypertension and impaired glucose tolerance (HTN+IGT) linked to cognitive impairment, increased white matter hyperintensities, and reduced gray matter perfusion.
  • Hypertension alone was associated with poorer cognition and lower gray matter perfusion.
  • No association found between cardiometabolic factors and gray matter macrostructure or cognitive status.

Conclusions:

  • Hypertension and its co-occurrence with impaired glucose tolerance negatively affect cognitive performance.
  • These cardiometabolic conditions are associated with reduced gray matter perfusion and impaired white matter microstructure, highlighting their role in Alzheimer's disease pathogenesis.
Abstract

Keywords:
Braincognitionhyperglycemiahypertension

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