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Updated: Jun 30, 2025
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Pressure control and treatment interact in the deterioration of incidental visuospatial memory in hypertensive
Miguel A López-Vázquez1, Javier Varela-Montes2, Martha L Serrano-Corral2
1División de Neurociencias, Centro de Investigación Biomédica de Michoacán, Delegación Regional Michoacán, Instituto Mexicano del Seguro Social (IMSS), Morelia.
Insights
Systemic hypertension impacts visuospatial memory. Effective blood pressure control and specific treatments like ARBs are crucial for maintaining cognitive function in hypertensive patients.
Area of Science:
- Neuroscience
- Cardiology
- Gerontology
Background:
- Systemic hypertension (SH) is a primary risk factor for cognitive decline.
- Visuospatial memory shows particular vulnerability to aging.
- Antihypertensive medications may offer neuroprotection, but this can be obscured by comorbidities or inadequate blood pressure control.
Purpose of the Study:
- To evaluate incidental visuospatial memory in patients with SH.
- To examine the relationship between memory function, antihypertensive treatment, and blood pressure control.
Main Methods:
- 80 patients were categorized based on medication: angiotensin 2 receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEI).
- Multiple correlation and mixed model analyses were employed to assess relationships between visuospatial scores, clinical variables, treatment, and pressure control.
Main Results:
- Half of the patients achieved controlled blood pressure, with a higher proportion on ARBs.
- Normotensive patients on ACEI showed lower efficiency, while hypertensive patients on ACEI were more efficient.
- Systolic pressure was negatively correlated with visuospatial scores, independent of MoCA and Raven test results.
Conclusions:
- Visuospatial memory scores directly correlate negatively with systolic blood pressure.
- The efficiency of visuospatial abilities is contingent upon the interplay between antihypertensive treatment and effective blood pressure management.
- Considering the interaction between treatment and blood pressure control is essential when investigating cognitive deterioration.
Background:
Systemic hypertension (SH) is the main risk factor to cognitive deterioration, whereas visuospatial memory is more vulnerable to ageing. Some antihypertensive agents have a neuroprotector effect, however, such effects could be masked by comorbidities and/or the lack of effective control on the arterial pressure of patients.
Objective:
To assess this, the evaluation of incidental visuospatial memory of SH patients and the relation to the treatment received and the effective control of pressure were made.
Method:
80 patients (46 woman) were included grouped by the received medication: angiotensin 2 receptor blockers (ARB) or angiotensin converting enzyme inhibitors (ACEI). A multiple correlation analysis between visuospatial scores and clinical variables was made; also, a mixed model analysis (fixed factors: treatment, pressure control, diabetes comorbidity; aleatory factors: age, schooling, months from SH diagnoses).
Results:
Half of the patients had a controlled pressure, from them the higher proportion received ARB, and a minor number of patients received ACEI. The normotensive patients receiving ACEI were inefficient whereas the hypertensive patients were more efficient. The systolic pressure was negatively related with the visuospatial scores in spite of no correlations occurred with MoCA and Raven tests.
Conclusions:
The visuospatial incidental/intentional scores were negatively correlated with systolic pressure. The efficiency in the visuospatial ability depends on the interaction of treatment and effective control of blood pressure. The interaction between treatment and effective pressure control must be taken in count when cognitive deterioration is studied.
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