Cognitive processes in hypertension.

Abstract

SUMMARY In IS normotensive subjects, 17 newly diagnosed, untreated hypertensive patients, and 22 effectively treated hypertensive patients, a battery of neuropsychological tests was given. All subjects were neurologically asymptomatic. The neuropsychological battery included tests evaluating global cognitive functions (Card Sorting Test, Wechsler Memory Scale, Progressive Matrices 1938), as well as specific cognitive functions (Benton Test, subtests of the Wechsler-Bellevue Scale). Normotensive controls obtained better scores in all the tests. Statistical analysis of the scores suggests that hypertension is highly correlated with impairment of memory, logical reasoning, visuospatial organization, and attention. Therapy seems to impair attention, while the duration of disease seems to influence visuospatial performances. (Hypertension 4: 226-229, 1982) KEY WORDS • hypertension • cognitive functions • neuropsychological tests R ECENT years have brought to light increasing evidence of the fundamental role played by arterial hypertension in the pathogenesis of stroke.1 "* In a high percentage of hypertensive patiets deceased without neurological complications, mild but diffuse cerebrovascular abnormalities have been found.*"* In spite of such frequent cerebral damage, neurological symptoms and signs seem to be rare and mild in hypertensive patients.* In our experience, hypertensive patients often report slightly impaired powers of concentration, lightheadedness, and easy fatigue, causing impaired intellectual performance.10 These symptoms might correlate with diffuse and mild cerebrovascular abnormalities, but might also be explained by neurophysiological cortical depression, clearly shown in experimental models, 11 or by emotional reactions to the illness.Personality and psychological factors predisposing to, sustaining, and determined by hypertension have been extensively investigated." These investigations, although interesting for a global approach to hypertensive patients, are beyond the aim of our study, which is to investigate the possible neuropsychological deficits induced by neurologically asymptomatic hypertension.For this purpose we compared the results obtained by normotensive and hypertensive subjects in a battery of widely used neuropsychological tests.

A Population-Based Study on Blood Pressure and Brain Atrophy in 85-Year-Olds

“…Although most cross-sectional studies in groups of younger and middle-aged individuals [31][32][33][34][35][36] report a lower cognitive performance in hypertensives compared with normotensives, studies in the elderly report less conclusive results. 34,[37][38][39][40] In line with this, the Rotterdam Elderly Study 41 reported that blood pressure was negatively correlated to cognitive performance before age 75 years, whereas there was a positive correlation above that age.…”

Blood Pressure and Risk of Dementia: Results from the Rotterdam Study and the Gothenburg H-70 Study

“…One could consider that subjects who use antihypertensive medication are the subjects with the severer atherosclerosis and are more susceptible to pressure drops causing inadequate blood flow through the brain. Systemic hypotension with associated reduced cerebral blood flow may give rise to a spectrum of Ruitenberg/Skoog/Ott/Aevarsson/ Witteman/Lernfelt/van Harskamp/ Hofman/Breteler ischaemic neuronal lesions in vulnerable areas of the brain [30], especially in watershed areas [30,31], and may also lead to ischaemic loss of myelin in the white matter [32]. Persons who survive until old age, despite atherosclerotic lesions, may require increasing levels of blood pressure to maintain an adequate cerebral blood flow.…”

Chronic, Severe Hypertension Does Not Impair Spatial Learning and Memory in Sprague-Dawley Rats

“…Nearly 25 yr ago, data from Wilke and Eisdorfer suggested that hypertension may lead to memory impairments (Wilkie et al 1976), and many subsequent reports have supported this relationship in humans (e.g., Franceschi et al 1982;Waldstein et al 1991;Elias et al 1993Elias et al , 1997Swan et al 1998); however, it remains unclear whether memory deficits and hypertension are causally related or simply coexist. Several additional studies suggest that high blood pressure contributes to cognitive deficits in aging individuals (e.g., Elias et al 1995;Skoog 1997), but other research indicates that cognitive function gradually declines with age in humans, irrespective of arterial pressure (e.g., Beatty 1988;Albert 1993) and that this age-related impairment extends to spatial learning and memory tasks (Sharps and Gollin 1987;Petersen et al 1992).…”