RELATIONSHIP BETWEEN COGNITIVE IMPAIRMENT AND HYPERTENSION MEDIATED ORGAN DAMAGE: THE VOBARNO STUDY

Abstract

Objective: Background Several studies have suggested the presence of a relationship between hypertension in mid-life and the subsequent development of mild cognitive impairment (MCI) and dementia. Aim: to analyze the relationship between baseline blood pressure (BP), cardiovascular risk factors and presence of Hypertension Mediated Organ Damage (HMOD) and cognitive performances oppler after a follow-up period of 12 years in 149 subjects participating into the Vobarno Study. Design and method: 149 subjects (52% female, mean age 54.9 ± 8, 9 ± 3.25 school years, 59% hypertensives) underwent blood chemistry, arterial pressure measurement, echocardiography, carotid oppler ultrasound and measurement of central arterial pressure (PWA) and carotid-femoral pulse wave velocity (PWV). All subjects underwent a neuropsychological evaluation with standardized tests performed at a follow-up visit 12 years later. Results: 57 subjects with MCI at follow-up had baseline higher arterial pressure values (SBP and PP clinical and 24 h p < 0.05), IMT (1.23 ± 0.34 vs 1.12 ± 0.25 p < 0.05), and PWV (11.45 ± 3.37 m/sec vs 10.49 ± 1.74 p < 0.05) than those observed in the 92 subjects without MCI. Subjects with MCI were divided in two groups according to presence of amnesia (18 and 21% of total, respectively). Baseline IMT was significantly higher in subjects who developed non-amnesic MCI when compared with patients without MCI (Meanmax 1.30 ± 0.36 mm vs 1.12 ± 0.25 mm p < 0.05; CBmax 1.30 ± 0.29 mm vs 1.16 ± 0.24 mm p < 0.05); no differences were found between amnesic and nonamnesic subjects. Conclusions: our results show that baseline presence of hypertension and HMOD may be associated with cognitive performance detected after a mean period of 10 years. Aortic stiffness (measured as PWV) appears to be a less sensitive predictor of cognitive decline than increased IMT.