title: Silent cerebral white matter lesions and cognitive function in middle-aged essential hypertensive patients.
abstract: BACKGROUND
  An association between midlife blood pressure levels and late-life cognitive impairment has been reported. Hypertension is one of the most important factors related to the presence of cerebral white matter lesions, which is a prognostic factor for the development of cognitive impairment. Studies have shown a relationship between white matter lesions and cognitive decline in elderly hypertensive patients. The aim of the present study was to evaluate cognitive function in asymptomatic middle-aged hypertensive patients according to the presence or absence of white matter lesions.
  
  
  METHODS
  Sixty never-treated essential hypertensive patients (38 men, 22 women), aged 50 to 60 years (mean age, 54.4 +/- 3.8 years), without clinical evidence of target organ damage, were studied. All patients underwent brain magnetic resonance imaging to establish the presence or absence of white matter lesions, using the Rotterdam criteria. Cognitive function was evaluated by a neuropsychologic test battery measuring attention, memory, intelligence, anxiety, and depression.
  
  
  RESULTS
  Twenty-three hypertensive patients (38%) were found to have white matter lesions on brain resonance. These patients exhibited a significantly worse performance on digit span forward, a standardized measure of attention than hypertensives without white matter lesions (4.86 +/- 1.14 v 5.51 +/- 0.97; P =.027). Hypertensive patients with white matter lesions showed no differences on both visual and logical memory tests when compared with patients without lesions.
  
  
  CONCLUSIONS
  We conclude that the presence of silent cerebral white matter lesions in middle-aged hypertensive patients is associated with a mild decline in basic attention.
authors.affiliation: Hypertension Unit, Department of Internal Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain. csierra@clinic.ub.es
authors.forename: Cristina
authors.initials: C
authors.lastname: Sierra
authors.forename: Alejandro
authors.initials: A
authors.lastname: De La Sierra
authors.forename: Manel
authors.initials: M
authors.lastname: Salamero
authors.forename: Javier
authors.initials: J
authors.lastname: Sobrino
authors.forename: Elisenda
authors.initials: E
authors.lastname: Gómez-Angelats
authors.forename: Antonio
authors.initials: A
authors.lastname: Coca
mesh_terms: D001794:Blood Pressure / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D003971:Diastole / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D013030:Spain; D013223:Statistics as Topic; D013599:Systole / Q000502:physiology