Glucose intolerance and diabetes as risk factors for cognitive impairment in people at high cardiovascular risk: results from the ONTARGET/TRANSCEND research programme.
OBJECTIVE
To assess the cross-sectional associations of the measures of glycemia and cognitive function in subjects at high cardiovascular risk.


METHODS



METHODS
The ONgoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial (ONTARGET) and concurrent Telmisartan Randomized Assessment Study in ACE intolerant Subjects with Cardiovascular Disease (TRANSCEND) are multi-center, randomized, controlled investigations of different approaches to angiotensin receptor blockade in over 30,000 high CV risk subjects. Baseline data in both trials was used to analyze relationships between measures of glycemic control and cognition.


RESULTS
The univariate and multivariate relationships between diabetes status, fasting plasma glucose (FPG), and scores on the Mini-Mental State Examination (MMSE) were assessed.


RESULTS
In subjects with diabetes, the mean MMSE score was 0.4 units lower than in those without diabetes (P<0.0001). In all subjects, a 1 mmol/L higher FPG value was associated with a MMSE score that was 0.06 units lower (P<0.0001). The association persisted after adjustment for several cardiovascular risk factors.


CONCLUSIONS
Dysglycemia is a risk factor for impaired cognitive function in this broadly representative, high-risk study population. Prospective studies can more reliably discern temporal associations, including the effects of glucose lowering in this clinical group.
Cukierman-Yaffe
Tali
T
Population Health Research Institute, McMaster University, Canada. cukierm@mcmaster.ca
Gerstein
Hertzel C
HC
Anderson
Craig
C
Zhao
Feng
F
Sleight
Peter
P
Hilbrich
Lutz
L
Jackson
Stephen H D
SH
Yusuf
Salim
S
Teo
Koon
K
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D001565:Benzoates / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000523:psychology*; D003925:Diabetic Angiopathies / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D018149:Glucose Intolerance / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology; D000077333:Telmisartan
D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D001786:Blood Glucose; D017257:Ramipril; D000077333:Telmisartan