Endothelial Activation Is Associated With Cognitive Performance in Patients With Hypertension.
BACKGROUND
Hypertension is associated with the occurrence of cognitive deficits and dementia, probably because hypertension is a major risk factor for the occurrence of brain damage as a result of cerebral small vessel disease (cSVD). Endothelial activation and inflammation have been suggested to play an important role in the pathogenesis of cSVD. We investigated if compound scores of endothelial activation or inflammation, based on several blood markers, are associated with cognitive performance 3 years later in patients with essential hypertension.


METHODS
At baseline, levels of blood markers of endothelial activation (soluble vascular cellular adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), sP-selectin, and sE-selectin) and markers of inflammation (neopterin, C-reactive protein, and sICAM-1) were measured and transformed into compound scores using z-scores. In addition, a brain magnetic resonance imaging (MRI) was performed to determine the presence of cSVD-related MRI markers. Three years later, patients underwent a neuropsychological assessment to determine cognitive performance.


RESULTS
A total of 101 patients with hypertension were included in the present study. In multiple linear regression analyses with correction for demographics and MRI markers, the compound score of endothelial activation (B = -0.19, 95% confidence interval = -0.34 to -0.04, P = 0.014), but not of inflammation (B = -0.09, 95% confidence interval = -0.22 to 0.05, P = 0.198), was associated with worse cognitive performance.


CONCLUSIONS
Our results show that an overall measure of endothelial activation is associated with cognitive performance in patients with essential hypertension. This indicates that a process involving endothelial activation might play a role in the pathogenesis of cognitive problems in patients with hypertension.
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands; renske.uiterwijk@mumc.nl.
Renske
R
Uiterwijk
Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands;
Marjolein
M
Huijts
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands;
Julie
J
Staals
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands;
Rob P W
RP
Rouhl
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
Peter W
PW
De Leeuw
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
Abraham A
AA
Kroon
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands;
Robert J
RJ
Van Oostenbrugge
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D015815:Cell Adhesion Molecules / Q000097:blood*; D003071:Cognition; D003072:Cognition Disorders / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology; D003661:Decision Support Techniques; D042783:Endothelial Cells / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D018836:Inflammation Mediators / Q000097:blood*; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018836:Inflammation Mediators
blood pressure; cerebral small vessel disease; cognition; endothelial activation; hypertension; inflammation.