Systemic arterial hypertension and cognition in adults: effects on executive functioning

Moraes, Natália Cristina; Muela, Henrique Cotchi Simbo; Memória, Cláudia Maia; Costa-Hong, Valéria; Machado, Michel Ferreira; Cechinhi, Mario Amore; Nitrini, Ricardo; Bortolotto, Luiz Aparecido; Yassuda, Mônica Sanches

doi:10.1590/0004-282x20200039

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…Naharci et al ( 39 ) found that blood pressure index (BPI) was associated with cognitive ability and might be a new alternative marker for identifying dementia risk in older adults. What is more, in the study of Natália Cristina Moraes, they also found that patients with systemic arterial hypertension (SAH) had a significant impairment in executive functions (EFs), more specifically in shifting and updating ( 40 ). Therefore, our conclusions were consistent.…”

Section: Discussionmentioning

confidence: 99%

Increase in Right Temporal Cortex Thickness Is Related to Decline of Overall Cognitive Function in Patients With Hypertension

Yue

Xiao

2021

Front. Cardiovasc. Med.

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Background: Hypertension is associated with poorer cognitive functions, but the mechanisms are unclear.Objective: This research aims to explore the cognitive status of elderly patients with hypertension and the possible mechanisms of hypertension affecting cognitive function.Methods: Data were obtained from the China Longitudinal Aging Study (CLAS), and a total of 128 residents, aged 60 years and above, were recruited in this study. Based on whether they had hypertension, these 128 people were divided into the hypertension (n = 64) and non-hypertension groups (n = 64). The Beijing version of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess the overall cognitive function of the subjects, while digit span, language fluency, Wechsler mapping, and Wechsler wood block were used to assess their domain-specific cognitive function (both at baseline and follow-up stages). At the same time, we also examined baseline blood biochemical indicators (such as total protein, fasting plasma glucose (FPG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, and triglyceride) and baseline MRI data of hippocampus and amygdala volume and temporal polar cortex thickness.Results: The total protein and thickness of temporal polar cortex in patients with hypertension were significantly higher than those in normal controls, but the scores on MMSE, MoCA, digit span, Wechsler mapping and Wechsler wood block at baseline were significantly lower than those in normal controls (p < 0.05). By linear regression analysis and correlation analysis (age and education were controlled), we found that baseline Wechsler mapping scores were negatively correlated with total protein (B = −0.243, t = −3,735, p < 0.001, 95% confidence interval (CI): −0.371 to −0.114); and both the follow-up MMSE score (B = 2.657, t = 2.002, p = 0.049, 95% CI: 0.009~5.306) and the change score of MMSE (r = −0.025, p = 0.047) were related to the thickness of the right temporal pole cortex. Then, by linear regression analysis (mediating model), we found that hypertension may influence follow-up MMSE scores by influencing the cortical thickness of the right temporal pole (B = 1.727, p = 0.022, 95% CI: 0.261–3.193).Conclusions: Elderly patients with hypertension exhibit poorer overall cognitive function and executive function, and the mechanism may be related to the effect of hypertension on the cortical thickness of the right temporal pole.

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Section: Discussionmentioning

confidence: 99%

Increase in Right Temporal Cortex Thickness Is Related to Decline of Overall Cognitive Function in Patients With Hypertension

Yue

Xiao

2021

Front. Cardiovasc. Med.

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“…In addition to being associated with stress ( Höfelmann et al, 2018 ; Khayyat et al, 2019 ; Samiei Siboni et al, 2019 ), AH can impact cognition in multiple domains ( Gifford et al, 2013 ; Muela et al, 2017 ). There is evidence that hypertensive individuals perform worse in tests that assess executive functions (EF) compared to healthy individuals ( Moraes et al, 2020 , 2019 ). Souza-Talarico et al (2020) also found that work-related stress was associated with lower performance on delayed recall, verbal fluency, and EF tests in middle-aged adults ( Souza-Talarico et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Higher Perceived Stress as an Independent Predictor for Lower Use of Emotion-Focused Coping Strategies in Hypertensive Individuals

et al. 2022

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IntroductionIndividuals with high scores of perceived stress (PS) are more likely to develop arterial hypertension (AH) than those with low levels of stress. In addition to this, AH and stress are both independent risk factors for executive function (EF) impairment and worse quality of life (QoL). Therefore, strategies to control and cope with emotional stress are of paramount importance. However, less is known about the association of PS with EF, QoL, and coping in individuals with hypertension. This study aimed to evaluate the association of PS with EF performance, coping strategies use, and QoL in a sample of hypertensive patients.MethodsWe assessed a group of 45 hypertensive individuals (mean age = 58.42 ± 8.9 years, 71.11% female). The EF evaluation was: Frontal Assessment Battery; Controlled Oral Word Association Test—FAS; Letter-Number Sequencing subtest from the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III); Digit Span subtest from the Wechsler Memory Scale-Revised (WMS-R) and Wisconsin Card Sorting Test. The type and frequency of coping strategies used were measured by the Brief Coping with Experienced Problems Scale (Brief-COPE). The World Health Organization Quality of Life Questionnaire Bref (WHOQOL-bref) was applied to measure QoL. The associations of the PS with EF performance, coping strategies, and QoL were investigated using univariate and multiple linear regression models adjusted for age, sex, education, systolic pressure, and depression symptoms.ResultsIn the multivariate analyses, higher PS was an independent predictor for a lower frequency of emotion-focused strategy use (β = −0.23; p = 0.03). However, PS was not significantly related to EF and Qol in this sample. The lower the PS, the greater the use of emotion-focused coping.ConclusionHypertensive individuals with high PS use less frequently positive emotion-focused coping strategies.

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“…Although our current understanding predominantly emphasize on the well-established effect of high blood pressure in the development of stroke, the impact on cognitive consequences appears to be independent of stroke [38,46]. The deleterious effects of hypertension on the brain targets the cerebral blood vessels with resultant structural and functional cerebrovascular alterations including white matter damage, frontal lobe dysfunction, small vessel disease, lacunar strokes, cerebral microhemorrhages, arteriosclerosis, silent brain infarcts, and brain atrophy [65][66][67][68][69][70][71][72][73][74][75][76]. As a consequence, hypertension is associated with reduced abstract reasoning (executive dysfunction), slowing of mental processing speed, loss of linguistic abilities, and attention and memory deficits [10,[77][78][79][80].…”

Section: Introductionmentioning

confidence: 99%

Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study

Pallangyo¹,

Mkojera²,

Komba³

et al. 2021

BMC Neurol

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Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. Methodology A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4–5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2–2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1–2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0–2.7, p = 0.04) to have independent association with cognitive impairment. Conclusion This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.

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Systemic arterial hypertension and cognition in adults: effects on executive functioning

Cited by 10 publications

References 29 publications

Increase in Right Temporal Cortex Thickness Is Related to Decline of Overall Cognitive Function in Patients With Hypertension

Increase in Right Temporal Cortex Thickness Is Related to Decline of Overall Cognitive Function in Patients With Hypertension

Higher Perceived Stress as an Independent Predictor for Lower Use of Emotion-Focused Coping Strategies in Hypertensive Individuals

Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study

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