Abstract
Objectives: High blood pressure represents a key factor in the development of cerebrovascular disease. The white matter lesions (WMLs) is structural attribute of hypertensive encephalopathy. Cognitive impairment also arises already at early stages of hypertension. There are important evidences that results of cognitive tests in predicting hypertensive targetorgan damage. The aim of the present study was to investigate the relationship among cognitive performances and structural changes in the brain in hypertensive patients without evidence of cognitive decline. Methods: We examined 45 asymptomatic, non complicated essential hypertensives, aged between 28–56 years. All patients underwent clinical exam, magnetic resonance (MRI) a brain, neurocognitive assessment by Wechsler Memory Scale (WMS). Magnetic resonance imaging was performed using Magnetom-Open with main field strength of 0.2 T. Results: In hypertensive patients WMLs met moderate impairment of attention in 72% of cases, at the impairment of attention- in 100% of cases. In patients moderate impairment of attention WMLs significantly met in subcortical areas (57%) (X2 = 44.81, ð = 0.0000) is more often, in patients the expressed impairment of attention WMLs significantly met in subcortical areas (50%) (x2 = 23.75, ð = 0.0000) and in the brain trunk (51%) (x2 = 13.33, ð = 0.0003) is more often. At patients with the moderate and expressed impairment of psychomotor speed WMLs were registered in 100% of cases. In patients impairment of psychomotor speed WMLs significantly met in subcortical areas (56%) (x2 = 27.5, ð = 0.0000) and in areas of talamus (78%) (x2 = 29.85, ð = 0.0000) is more often. Conclusions: Cognitive performances are strongly associated to WMLs. The simple cognitive tests allow to predict a degree of hypertensive encephalopathy and to spend differentiated therapy.
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