Association of Hypertension with Mild Cognitive Impairment in Population from Less-Developed Areas of Multiethnic Northwest China

Abstract

<b><i>Background:</i></b> Relationship between hypertension and mild cognitive impairment (MCI) remains undetermined in population from less-developed regions. We aimed to explore whether hypertension is associated with MCI in this specific population. <b><i>Methods:</i></b> In this cross-sectional study, we enrolled subjects aged ≥18 years using multistage random sampling from Emin, China, in 2019. Participants underwent questionnaires and data collection including mini-mental state examination (MMSE) and blood pressure measurement. <b><i>Results:</i></b> Finally, 31,329 subjects were included, with 11,270 hypertensives. Compared with normotensive subjects, hypertensives were characterized by significantly older age (55.19 ± 12.25 vs. 43.26 ± 12.71), more men (52.5% vs. 42.9%), low education attainment (≤primary education: 42.4% vs. 26.3%), more abdominal obesity (39.7% vs. 19.1%), poor sleep quality (39.1% vs. 28.7%), and chronic kidney disease (6.6% vs. 3.4%, <i>p</i> for all <0.001). Prevalence of MCI in hypertensives was significantly higher than that of normotensive subjects (24.3% vs. 15.6%, <i>p</i> < 0.001). Multivariate logistic regression analysis showed in a fully adjusted model that the odds for MCI were significantly increased in hypertensives than in normotensive population (OR = 1.19, 95% CI: 1.09, 1.30, <i>p</i> < 0.001) and independent of all the parameters studied including age, education level, and stroke. In the age-stratified regression model, presence of hypertension significantly increased the odds of MCI by 1.17-fold (95% CI: 1.03, 1.33, <i>p</i> = 0.020) and by 1.22-fold (95% CI: 1.04, 1.44, <i>p</i> = 0.016) in middle-aged and elderly population. Sensitivity analysis of excluding those with stroke history showed that hypertension was still a risk factor for MCI in total, middle-aged, and elderly population. <b><i>Conclusion:</i></b> Hypertension is in independent negative association with MCI in middle-aged and elderly population from underdeveloped regions.

Association of Type D personality and mild cognitive impairment in patients with hypertension

“…For instance, Muela et al (2017) confirmed that age was independent predictors of MCI in patients with hypertension in different cognitive domains. Our results showed that age, smoking history and medication adherence were associated with MCI in patients with hypertension, which is consistent with the results of previous studies ( Heizhati et al, 2021 ; Paradela et al, 2021 ; Yamamoto et al, 2022 ). Moreover, coronary heart disease, obesity, anxiety and depression can interfere with MCI ( Heizhati et al, 2021 ; Yamamoto et al, 2022 ), however, these variables were not related to MCI in our study.…”

“…Multivariable analysis was employed to determine the relationship between Type D personality and MCI in hypertensive individuals. Identify covariates based on previous literature ( Heizhati et al, 2021 ; Paradela et al, 2021 ; Yamamoto et al, 2022 ). Age and sex were entered as standard control variables.…”

“…Thus, it is one of great significance to understand the risk factors associated for MCI in order to reduce the risk of dementia in patients with hypertension ( Kim et al, 2013 ). Studies of traditional risk factors, such as age, education, income, diabetes and dyslipidemia, have helped identify subgroups of hypertensive individuals who are at risk of cognitive impairment ( Heizhati et al, 2021 ; Paradela et al, 2021 ; Yamamoto et al, 2022 ). However, the psychosocial risk factors have received less attention, especially the personality traits.…”

Association of objective and subjective parameters of obstructive sleep apnea with plasma aldosterone concentration in 2,066 hypertensive and 25,368 general population

“…In addition, a positive independent linear association between log No-SAS score and log PAC was observed, consistent in age-stratified analysis. Previous relevant studies were conducted mainly in resistant hypertension, in which PA accounts for as high as 36% ( 25 ) and as high as 22.0% of general hypertension ( 26 , 27 ). These results are consistent with those of our clinical data and with those of previous studies ( 18 – 20 , 24 ).…”

“…In general population data, for men participants, age was categorized into <45, 45–60, and ≥60 years according to the criteria from the World Health Organization for developing countries ( 25 , 27 ); for women participants, age was categorized into <51 and ≥51 years as a cutoff age for menopausal status based on previous studies ( 34 ). Educational attainment status was categorized into <9 and ≥9 years.…”