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Updated: Jul 15, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Muscle Ultrasound Parameters and Cognitive Function in H‑type Hypertension: A Cross-Sectional Study
Xiao-Fen Weng1, Song-Tao Li2, Yan Cui1
1Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, Jiangsu, People's Republic of China.
Background:
H-type hypertension is associated with an increased risk of cognitive impairment, but the relationship between muscle ultrasound parameters and cognitive function in this population remains unclear. This cross-sectional study investigated the association between muscle ultrasound parameters and cognitive function in patients with H-type hypertension and sought to identify ultrasound parameters associated with cognitive status.
Methods:
This cross-sectional study included 125 patients with H-type hypertension. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Participants were classified into non-cognitive impairment (n = 68) and cognitive impairment (n = 57) groups. Muscle thickness (MT), muscle cross-sectional area (MCSA), shear wave velocity (SWV), and pennation angle (PA) were measured at selected upper- and lower-limb muscles. Partial correlation analysis, multivariable linear regression, and binary logistic regression were performed to examine associations between ultrasound parameters and cognitive status.
Results:
Compared with the non-cognitive impairment group, the cognitive impairment group had significantly lower MT and MCSA at multiple sites, including the biceps brachii, brachioradialis, rectus femoris, and lateral gastrocnemius (all P < 0.05), whereas SWV and PA did not differ significantly. After adjustment, rectus femoris MT showed the strongest correlation with total MoCA score (r = 0.470, P < 0.001). Rectus femoris MT remained independently associated with total MoCA score (B = 0.509, 95% CI: 0.330-0.688, P < 0.001) and cognitive impairment (OR = 0.811, 95% CI: 0.706-0.933, P = 0.003).
Conclusion:
Reduced rectus femoris MT is independently associated with poorer cognitive function and the presence of cognitive impairment in patients with H-type hypertension. Rectus femoris MT may serve as a useful adjunctive ultrasound marker of concurrent cognitive status, but prospective studies are needed to determine its clinical utility.
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Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.