title: Cognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos.
abstract: BACKGROUND
  Hypertension control in Hispanics/Latinos lag behind general US trends by 10-15%. Intensive systolic blood pressure (SBP) management <120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP < 140 mm Hg) and more intensive (SBP < 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos.
  
  
  METHODS
  From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45-74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English.
  
  
  RESULTS
  Separate linear regressions revealed that being on 1 vs. >1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P < 0.01] and information processing speed [Beta = 3.01 (0.89), P < 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P < 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels <120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P < 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P < 0.05).
  
  
  CONCLUSIONS
  Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies.
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.|Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Lamar
authors.affiliation: Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Donghong
authors.initials: D
authors.lastname: Wu
authors.affiliation: Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Ramon A
authors.initials: RA
authors.lastname: Durazo-Arvizu
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain and the Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA.
authors.forename: Hector M
authors.initials: HM
authors.lastname: Gonzalez
authors.affiliation: Institute of Gerontology, Wayne State University, Detroit, Michigan, USA.
authors.forename: Wassim
authors.initials: W
authors.lastname: Tarraf
authors.affiliation: Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.|Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003071:Cognition; D003430:Cross-Sectional Studies; D056344:Executive Function; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents
keywords: HCHS/SOL; Hispanics/Latinos.; antihypertensive treatment; blood pressure; blood pressure control; cognition; hypertension