White-coat and masked hypertension and cognitive impairment

Abstract

Purpose: Patients with isolated office or isolated ambulatory hypertension are at an elevated cardio-vascular risk than the general population. The purpose of this study is to evaluate the risk for cognitive impairment in patients with white-coat or masked hypertension, and to compare it with risk of cognitive impairment in the other hypertensive patients. Methods: A prospective study of 953 hypertensive patients on combination therapy. Mean age was 66.01±9.98 years. 359 (37.67%) were males and 594 (62.32%) females. 269 (28.23%) of the patients were reevaluated after a mean period of 12 months (min.6 and max.20). Blood pressure was registered with self-measurement, office-measurement and ambulatory monitoring with regard to the recommendations. Neuropsychological screening for mild cognitive impairment was conducted via Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results: 114 (11.96%) of the patients were with "white-coat" hypertension and 126 (13.22%) - with "masked" hypertension. 49 (42.98%) of the patients with "white-coat" and 90 (71.43%) of those with "masked" hypertension had mild cognitive impairment. There wasn't any significant difference between the mean values of neuropsychological tests' results (at p=0.05) between the standard group of hypertensive patients and those with "white-coat" or "masked" hypertension. Conclusion: Patients with "white-coat" and "masked" hypertension are at the same risk for cognitive impairment (as a target organ damage), as the other hypertensive patients. They should be screened for cognitive impairment. This is important for the timely prophylaxis of dementia.