Cross Section Case Control Study for Clinical Correlates of Cognitive Impairment in Patients with Midlife Early Hypertension: Differential effect of Antihypertensives

Hatem Elmassry, Nahla Nagy, Iman Shorab, Maissa Eid


High blood pressure (BP) is considered a risk factor for cerebrovascular disease, including stroke. Little is known about the importance of BP on the progression of microvascular disease of the brain, and cognitive impairment. In this study 85 patients (45 women and 40 men; age range 40-55) were assessed for blood pressure with the mean value of the 2 measurements of 2 visits that were calculated and analysed. Cognitive testing was performed using a combination of 4 well-validated standardized tests: the Mini Mental State Examination, Trail Making Test (TMT) A, (TMT) B, and a verbal fluency test. The control group of 60 normal volunteers matched for age, sex and education without changes in blood pressure were compared for cognitive changes. Result show significant difference between patients and controls in cognitive tests (p=0.000) and positive correlation between hypertension and cognitive impairment, that was more associated with elevated systolic blood  pressure, older age, male sex and early onset hypertension. Positive correlation was also found with improved cognitive functions in hypertensive patients using diuretics, angiotensin II inhibitors and antihypertensive combination. The results indicate that midlife early high BP levels increase the risk for cognitive impairment and dementia. This association may be modified by antihypertensive medication.

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