Abstract 004: Antihypertensive Treatment Stops Cognition Decline in Elderly Chinese With Hypertension

Abstract

Background: Hypertension and cognition decline are common problems among mid-aged and elderly populations. We examined the impact of hypertension and its treatment on cognitive function between 2011 and 2015 using the China Health and Retirement Longitudinal Study (CHARLS). Methods: A national sample of 10958 mid-aged and elderly Chinese was followed for four years. Hypertension was defined by a mean systolic blood pressure of ≥ 140 mmHg or a mean diastolic blood pressure of ≥ 90 mmHg or by antihypertensive treatment. Cognition was estimated by a composite score of the Telephone Interview of Cognition Status (TICS) (score range: 0-11) and the immediate and delayed recall of 10 simple nouns (score range: 0-10). In linear regression models, the relation between hypertension status, treatment, and cognitive decline over time was examined in different age groups adjusting for baseline cognition score. We further examined the role of selected covariates related to hypertension and cognition, including gender, education level, and residency (rural vs urban). Results: Overall cognition scores declined significantly from 11.01(SD: 3.96) in 2011 to 10.24 (SD: 4.29) in 2015 (p < 0.01). For participants aged 55 years and over (n = 6971), the cognition of hypertensive patients who were not aware of their condition (n = 1377) showed a 0.57 point larger decline (p < 0.01) compared to participants without hypertension (n = 4128); patients on antihypertensive treatment (n = 1466) showed a 0.56 point smaller cognition decline (p < 0.01) compared to patients who were not aware of their condition. The cognition decline of patients on antihypertensive treatment was comparable to the decline among non-hypertensive participants, (difference: -0.01 p = 0.96). Results were similar after adjusting for education, gender, and residency. For participants aged 45 to 54 years, there were no differences in cognition decline comparing any of these groups. Conclusions: Hypertension may accelerate cognitive decline over a four-year observational period in elderly Chinese but this decline is counteracted by antihypertensive treatment. Efforts to expand medical insurance for hypertension and treatment for the elderly in China may therefore also delay cognition decline in this population.