title: Hypertension Severity Is Associated With Impaired Cognitive Performance.
abstract: Most evidence of target-organ damage in hypertension (HTN) is related to the kidneys and heart. Cerebrovascular and cognitive impairment are less well studied. Therefore, this study analyzed changes in cognitive function in patients with different stages of hypertension compared to nonhypertensive controls.
  
  
  
  In a cross-sectional study, 221 (71 normotensive and 150 hypertensive) patients were compared. Patients with hypertension were divided into 2 stages according to blood pressure (BP) levels or medication use (HTN-1: BP, 140-159/90-99 or use of 1 or 2 antihypertensive drugs; HTN-2: BP, ≥160/100 or use of ≥3 drugs). Three groups were comparatively analyzed: normotension, HTN stage 1, and HTN stage 2. The Mini-Mental State Examination, Montreal Cognitive Assessment, and a validated comprehensive battery of neuropsychological tests that assessed 6 main cognitive domains were used to determine cognitive function. Compared to the normotension and HTN stage-1, the severe HTN group had worse cognitive performance based on Mini-Mental State Examination (26.8±2.1 vs 27.4±2.1 vs 28.0±2.0; P=0.004) or Montreal Cognitive Assessment (23.4±3.7 vs 24.9±2.8 vs 25.5±3.2; P<0.001). On the neuropsychological tests, patients with hypertension had worse performance in language, processing speed, visuospatial abilities, and memory. Age, hypertension stage, and educational level were the best predictors of cognitive impairment in patients with hypertension in different cognitive domains.
  
  
  
  Cognitive impairment was more frequent in patients with hypertension, and this was related to hypertension severity.
authors.affiliation: Hypertension Unit, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil henrimuela@hotmail.com.|Department of Physiology, Faculty of Medicine, Agostinho Neto University, Luanda, Angola.
authors.forename: Henrique C S
authors.initials: HC
authors.lastname: Muela
authors.affiliation: Hypertension Unit, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Valeria A
authors.initials: VA
authors.lastname: Costa-Hong
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Mônica S
authors.initials: MS
authors.lastname: Yassuda
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Natália C
authors.initials: NC
authors.lastname: Moraes
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Memória
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Michel F
authors.initials: MF
authors.lastname: Machado
authors.affiliation: Hypertension Unit, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Thiago A
authors.initials: TA
authors.lastname: Macedo
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Edson B S
authors.initials: EB
authors.lastname: Shu
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Ayrton R
authors.initials: AR
authors.lastname: Massaro
authors.affiliation: Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nitrini
authors.affiliation: Hypertension Unit, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Alfredo J
authors.initials: AJ
authors.lastname: Mansur
authors.affiliation: Hypertension Unit, Heart Institute (Incor), University of São Paulo Medical School, São Paulo, Brazil.
authors.forename: Luiz A
authors.initials: LA
authors.lastname: Bortolotto
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents
keywords: cognition; cognitive impairment; high blood pressure; hypertension