Cognitive impairment is related to increased arterial stiffness and microvascular damage in patients with never-treated essential hypertension.
BACKGROUND
It is known that essential hypertension may be implicated in the development of cognitive impairment that is associated to microvascular disease of the brain. It has been hypothesized that increased arterial stiffness of the large arteries may lead to microvascular changes due to increased pulsatile flow. Our study tests the hypothesis that large artery stiffness and microvascular damage are related to brain microcirculation changes as reflected by impaired cognitive function.


METHODS
We studied 110 nondiabetic patients aged 40-80 years (mean age 53.8 +/- 11.2 years, 57 men) with recently diagnosed stage I-II essential hypertension. Mini-Mental State Examination (MMSE) was used as a screening test for global cognitive impairment. We performed both 2-D echocardiography and carotid-femoral pulse wave velocity (PWV) in order to evaluate arterial stiffness. Twenty-four hour urine microalbumin excretion was measured as a marker of microvascular damage.


RESULTS
In the entire population, MMSE was negatively correlated with age (r = -0.42, P < 0.001), 24-h pulse pressure (PP) (r = -0.18, P < 0.05), and PWV (r = -0.3, P = 0.003). Additionally, MMSE was not independently correlated with microalbuminuria in patients aged over 65 years (r = -0.58, P = 0.003).


CONCLUSIONS
Impaired cognitive function is associated with increased large artery stiffness and microalbumin excretion in newly diagnosed, untreated hypertensive patients. These findings support the hypothesis that cognitive impairment induced by impaired microcirculation is linked to large artery stiffness and microvascular damage.
Triantafyllidi
Helen
H
2nd Department of Cardiology, Medical School, University of Athens, Attikon Hospital, Athens, Greece. seliani@hotmail.com
Arvaniti
Chrysa
C
Lekakis
John
J
Ikonomidis
Ignatios
I
Siafakas
Nikolaos
N
Tzortzis
Stavros
S
Trivilou
Paraskevi
P
Zerva
Loukia
L
Stamboulis
Eleftherios
E
Kremastinos
Dimitrios Th
DT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000503:physiopathology; D001158:Arteries / Q000502:physiology; D001794:Blood Pressure; D003072:Cognition Disorders / Q000209:etiology*; D004548:Elasticity / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D014655:Vascular Resistance / Q000502:physiology