Abstract P084: When To Expect And Why To Analyze Cognitive Disorders In Arterial Hypertension

Abstract

To study the relationship between quality of life (LQ) and cognitive impairment, as well as to identify risk factors for their development in patients with arterial hypertension (AH). Examined 509 outpatients with controlled AH stage II with SCORE risk of CVD <5 %. Non-dementia cognitive impairment were found 24,32±0,11 points on МCA scale in 164 (32.2 %). Patients also demonstrated a significant (p <0.001) decrease in the LQ indicators on all SF-36 scales compared to healthy ones by an average of 24.5-66.0 points. According to the results of correlation analysisthe most significant was the direct relationship between cognitive impairment on МCA scale and assessment of physical health (rs=+0,65; p<0,001), mental health (rs=+0,60; p<0,001), life activity limitations (rs=+0,33; p<0,001) and social activity (rs=+0,35; p<0,001), indicating an association between deterioration in LQ components and cognitive impairment.It turned out that the risk factors for developing cognitive impairment with AH were a history of cognitive impairment in close relatives (2.79 (95 % CI 1.15-6.77) compared with healthy people and 2.41 (95 % CI 1.01-5.88) - AH patients without cognitive impairment), a high vegetative index (rs +0.15; p <0.05) according to daily monitoring of BP and elevated levels of systolic BP variability in day and at night, that increased the chances of developing cognitive impairment in AH patients by 2.11 times, (rs = + 0.57 and rs = + 0.61; p<0.001). It was found that the likelihood of developing cognitive impairment exceeds 50 % (high risk) if the level of systolic BP variability is above 12 mm Hg in day (area under ROC curve AUC = 0.891; 95 % CI 0.883-0.940. (AUC = 0.891; 95 % CI 0.883-0.940; ST = 82.5 % and SP = 92.9 %) and at night – over 10 mm Hg (AUC = 0.922; 95 % CI 0.861-0.963; ST = 82.5 % and SP = 85.7 %) according to daily BP monitoring. In patients with AH for more than 10 years with dissatisfaction of life quality, even with controlled blood pressure, the presence of cognitive impairment needs to be clarified in immediate families, and pay attention to the high autonomic index and variability of systolic blood pressure monitored day and night, due to the high risk of development and progression of cognitive impairment, which worsens the prognosis of cardiovascular events.