title: Hypertension and cognitive decline: impact on executive function.
abstract: Hypertension is a risk factor for mild cognitive deterioration and vascular dementia. Cognitive deterioration attributable to normal aging was distinguished from cognitive deterioration related to hypertension by means of neuropsychologic tests. Sixty hypertensive patients, aged 65-80 years, were compared with 30 normotensive individuals. Patients with a history of stroke and/or transient ischemic attacks, diabetes, atrial fibrillation, hypercholesterolemia, or bypass surgery, and those diagnosed with dementia, depression, or anxiety, were excluded. Neither gender differences, duration of hypertension (10.2+/-8.2 years), nor prescribed antihypertensive drug treatment had an influence on study results. Immediate recall was impaired in both groups. The hypertensive patients evinced impairment in all tests vs. the normotensive subjects. Mean deferred recall scores +/- SD were 5.68+/-2.6 vs. 7.13+/-2.4; p<0.01. Deficits in attention speed and executive function, as measured by nonperformance on the Trail Making Test Part B, were present in 46% of hypertensive patients vs. 13% of normotensive patients (p<0.005), with more errors made by the hypertensive patients (1.15+/-1.54 vs. 0.46+/-0.9; p<0.02). Scores on the Stroop Color and Word Test also revealed deficits in the hypertensive patients (24.7+/-7.6 vs. 32+/-10.7; p<0.005). Compared with the control group, the hypertensive participants revealed more deficits in skills involving delayed recall and prefrontal-region skills. The relevant neuropsychologic tests were sufficiently sensitive and proved easy to use in clinical practice.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Hospital Español, Buenos Aires, Argentina. avicario@cardioweb.net.ar
authors.forename: Augusto
authors.initials: A
authors.lastname: Vicario
authors.forename: Carlos D
authors.initials: CD
authors.lastname: Martinez
authors.forename: Dolores
authors.initials: D
authors.lastname: Baretto
authors.forename: Alejandra
authors.initials: A
authors.lastname: Diaz Casale
authors.forename: Liliana
authors.initials: L
authors.lastname: Nicolosi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D003071:Cognition; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests; D026941:Sodium Channel Blockers / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D026941:Sodium Channel Blockers