When to expect cognitive disorders in hypertension

Abstract

Abstract In large-scale clinical studies, age, arterial hypertension (AH), multi-focal atherosclerosis, and cognitive disorders (CD) are interrelated, affecting the level of disability, quality of life, and social adaptation of patients with cardiovascular diseases. Aim of the study To determine the prognostic criteria for cognitive disorders in patients with hypertension. Methods To achieve the aim of the study, the examinations were performed in 182 outpatients with AH II stage, 34–68 years, in 164 of them were CD according to neuropsychological tests of MMSE and MoCA, mostly of mild and moderate degree. The relationship between clinical data, cognitive function characteristics and daily monitoring data of hypertension were evaluated. The data obtained were analyzed using medical methods statistics. Results Among factors such as age (>60 years), gender (male / female), disease duration (>10 years), waist circumference, overweight or obesity, hypercholesterolemia, no influence on the development of CD was detected (p>0.05)). Risk factors for the development of CD in hypertension were an burdensome history of CD in closest relatives (2.79 (95% CI 1.15–6.77) relative to practically healthy individuals and 2.41 (1.01–5.88)), high vegetative index (rs +0,15; p<0,05). The correlation between CD and high rates of blood pressure variability according to daily monitoring of blood pressure in patients with hypertension, even under conditions of blood pressure control, is confirmed by the results of correlation and one-factor logit analysis. Thus, elevated levels of systolic blood pressure variability in the day and at night increased the chances of developing CD in patients with hypertension 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 blood pressure variability is above 12 mm Hg in the 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 blood pressure monitoring. Conclusion The prognosis for the development of cognitive impairment in arterial hypertension is influenced by: evidence of family CD history, autonomic nervous system index and variability of day and night blood pressure characteristics, according to ambulatory daily monitoring data. Funding Acknowledgement Type of funding source: None