title: Impaired cognitive executive dysfunction in adult treated hypertensives with a confirmed diagnosis of poorly controlled blood pressure.
abstract: BACKGROUND
  High blood pressure (BP) poses a major risk for cognitive decline. Aim of the study was to highlight the relationship between cognitive assessment scores and an effective therapeutic BP control.
  
  
  METHODS
  By medical visit and ambulatory BP monitoring (ABPM), we studied 302 treated hypertensives, subdivided according to office/daytime BP values into 120 with good (GC) and 98 poor (PC) BP control, 40 with "white coat hypertension" (WCH) and 44 a "masked-hypertension" phenomenon (MH). Patients underwent neuropsychological assessment to evaluate global cognitive scores at the Mini Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) and attention/executive functions (Delayed Recall, Digit Span Forwards, Digit Span Backwards, Selective Attention, Verbal Fluency, Stroop Test and Clock Drawing). Carotid intima-media thickness (IMT) served as the index of vascular damage.
  
  
  RESULTS
  There were no differences among the groups in terms of gender, age, education, metabolic assessment, clinical history and hypertension treatment. GC presented lower office and ambulatory BP values and IMT. PC performed worse than GC on global executive and attention functions, especially executive functions. In PC, office systolic BP (SBP) was significantly associated to the MMSE and FAB scores and, in particular, to Verbal Fluency, Stroop Errors and Clock Drawing tests. Office diastolic BP (DBP) was associated to Selective attention, nocturnal SBP to Digit Span backwards and Verbal Fluency. Worse cognitive assessment scores were obtained in WCH than GC.
  
  
  CONCLUSIONS
  The findings showed that in adult treated hypertensives, a poor BP control, as both doctor's office and daytime scores, is associated to impaired global cognitive and especially executive/attention functions.
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Christian
authors.initials: C
authors.lastname: Spinelli
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Maria Fara
authors.initials: MF
authors.lastname: De Caro
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Schirosi
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Mezzapesa
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: De Benedittis
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Chiapparino
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Serio
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Federico
authors.affiliation: Department of Medical Basic Sciences, Neurosciences and Sense Organs, Division of Neurology-Stroke Unit, Hypertension, Medical School of Bari - University of Bari, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Nazzaro
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001794:Blood Pressure; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000145:classification / Q000150:complications / Q000473:pathology*; D008875:Middle Aged; D012307:Risk Factors; D059466:White Coat Hypertension / Q000145:classification / Q000150:complications / Q000473:pathology*
chemical_list: D000959:Antihypertensive Agents
keywords: ambulatory blood pressure monitoring.; blood pressure control; cognitive dysfunction; executive impairment