COGNITIVE FUNCTION AND CAROTID STRUCTURE OVER LONG-TERM OBSERVATION IN PATIENTS WITH RESISTANCE HYPERTENSION

Abstract

Objective: to investigate the changes of cognitive function and carotid structure in patients with résistance hypertension (RH) over 24 months observation Design and method: In 51 pts with RH (average age 52,3 ± 0,9; 27 males) we measured ultrasonographically diameter (D) of common carotid arteries (CCA), carotid intima-media thickness (IMT) value at the carotid bifurcations and at the level of CCA, blood flow velocities (BFV) of CCA, internal carotid arteries (ICA) and cognitive function by Montreal cognitive assessment (MoCA) test twice: at baseline and after 24 months. Changes in D CCA, IMT and MoCA test were defined as a difference between subject's baseline D CCA, IMT, MoCA test and subsequent measurements obtained 24 months later. All pts received 4 antihypertensive drugs during observation period Results: systolic and diastolic blood pressure were significantly decreased at the end of observation period. Carotid diameter and IMT value at the level of CCA were significantly decreased during observation period (DCCA from 8,6 ± 0,03 to 8,3 ± 0,03 mm, p = 0,02, CCA IMT from 1,24 ± 0,02 to 1,11 ± 0,02 mm, p = 0,01). IMT value at carotid bifurcation didn’t change significantly. We observed improvement in cognitive function: MoCA test results at baseline was 22,2 ± 0,5 after 24 months - 24,9 ± 0,5. The end diastolic BFV in CCA, ICA were significantly increased (accordingly: CCA – 0,14 ± 0,03 vs 0,34 ± 0,03m/s, p = 0,001, ICA – 0,23 ± 0,02 vs 0,48 ± 0,03m/s, p = 0,001) and resistance index (RI) of ICA was significantly decreased from 0,65 ± 0,02 to 0,61 ± 0,02. Changes of peak systolic BFV were not significant. Changes of MoCA results were related to IMT value at the level of CCA at baseline and at the end of observation (accordingly: r = -0,81; p < 0,01 and r = -0,79; p < 0,02). The same relations were between MoCA results and IMT value at bifurcation CCA. Conclusions: our 24 months study showed the positive dynamics of cognitive function and carotid structure such as decreasing of carotid diameters, intima-media thickness at level CCA and carotid resistance in patients with resistance hypertension who were receiving antihypertensive treatment.