RELATIONSHIP BETWEEN COGNITIVE IMPAIRMENT AND PARAMETERS OF CLINIC AND 24H BLOOD PRESSURE IN ESSENTIAL HYPERTENSIVE PATIENTS

Abstract

Objective: To evaluate the relationship between values of clinic and 24 h blood pressure (BP) and cognitive function values in pts with essential hypertension (EH) Design and method: 24 h blood pressure monitoring was performed in 139 pts (51,5 ± 0,94 years; 87 males) with EH. Clinic (C) BP (average of 3 measures), 24 h, daytime (D) and nighttime (N) BP, 24 h BP index (I) were obtained separately for systolic (SBP) and diastolic (DBP) values. We took standard deviations (SD) for SBP and DBP during diurnal (D) and nocturnal (N) periods of monitoring as a measure of BP variability (mmHg). Cognitive function was assessed in all pts by Montreal cognitive assessment (MoCA) test. All patients were divided into 2 groups depending on the MoCA Results: group I (n = 75) – MoCAscore > or = 26, group II (n = 64) - MoCA score<26. Results: Pts of II gr. had significantly higher C and 24hDBP than pts of I gr. (accordingly: C DBP – 99,9 ± 3,1 vs 86,7 ± 3,4 mmHg, p < 0,05, 24hDBP – 95,6 ± 2,7 vs 84,00 ± 3,0 mmHg, p < 0,05). Values of C, 24 h, D and N SBP were not significantly different between two groups. Bivariate correlation analyses have shown that MoCA results related to N SBP (r = −0,34; p < 0,01), C DBP (r = −0,32; p < 0,02), 24hI SBP (r = 0,46; p < 0,001) and variability of D DBP (r = −0,30; p < 0,03). Adjustment for age and hypertension duration did not abolish these relationships. Multiple regression analysis have shown that only 24hISBP, 24hIDBP and variability of D DBP are predictors of MoCA results in pts with EH. Conclusions: cognitive function in pts with EH depend on level of clinic and 24 h DBP, BP rhythm and variability of DBP during diurnal period. Values of BP rhythm and variability of DBP during diurnal period are predictors of cognitive impairment in pts with EH.