title: Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study.
abstract: OBJECTIVE
  To determine the independent effects of obesity and hypertension on cognitive functioning.
  
  
  METHODS
  Using a prospective design, male (n=551) and female (n=872) participants of the Framingham Heart Study were classified by presence or absence of obesity and hypertension based on data collected over an 18-y surveillance period. All subjects were free from dementia, stroke, and clinically diagnosed cardiovascular disease up to the time of cognitive testing. Statistical models were adjusted for age, education, occupation, cigarette smoking, alcohol consumption, total cholesterol, and a diagnosis of type II diabetes. Body mass index status (nonobese or obese) and blood pressure status (normotensive or hypertensive) were then related to cognitive performance (learning, memory, executive functioning, and abstract reasoning) on tests administered 4-6 y later.
  
  
  RESULTS
  Adverse effects of obesity and hypertension on cognitive performance were observed for men only. Obese and hypertensive men performed more poorly than men classified as either obese or hypertensive, and the best performance was observed in nonobese, normotensive men.
  
  
  CONCLUSIONS
  The adverse effects of obesity and hypertension in men are independent and cumulative with respect to cognitive deficit.
authors.affiliation: Department of Mathematics and Statistics, Statistics and Consulting Unit, Boston University, MA 02215, USA. mfelias@aol.com
authors.forename: M F
authors.initials: MF
authors.lastname: Elias
authors.forename: P K
authors.initials: PK
authors.lastname: Elias
authors.forename: L M
authors.initials: LM
authors.lastname: Sullivan
authors.forename: P A
authors.initials: PA
authors.lastname: Wolf
authors.forename: R B
authors.initials: RB
authors.lastname: D'Agostino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000523:psychology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009765:Obesity / Q000150:complications / Q000523:psychology*; D011446:Prospective Studies; D012737:Sex Factors