Hypertension Is Related to Cognitive Impairment

TLDR

High blood pressure has been linked to later dementia, suggesting hypertension may cause cerebral target‑organ damage and contribute to preventable senility. This study aimed to assess how hypertension, circadian blood‑pressure patterns, and impaired glucose metabolism affect cognitive function in older men. The authors followed 999 70‑year‑old men from a Uppsala cohort, measuring 24‑hour ambulatory BP, insulin sensitivity, glucose tolerance, lipids, and cognitive performance via MMSE and Trail‑Making Test. High diastolic BP predicted later cognitive decline, and at age 70, elevated 24‑hour BP, nondipping patterns, insulin resistance, and diabetes were all associated with poorer cognition, especially in untreated men, indicating hypertension and metabolic disturbances are risk factors for cognitive disorders and support early intervention.

Abstract

Abstract —Recent findings of a linkage between high blood pressure (BP) and later development of dementia have given new prospects on cerebral target-organ damage in hypertension and have added substance to the concept of “preventable senility.” The aim of this study was to analyze the impact of hypertension, circadian BP profile, and disturbed glucose metabolism on cognitive function. The study population consisted of 999 seventy-year-old men from a population-based cohort study in Uppsala, Sweden, followed with respect to cardiovascular risk factors since the age of 50 years. At the age of 70, 24-hour ambulatory BP was monitored together with measurements of insulin sensitivity, glucose tolerance, serum lipids, and lipoproteins. Cognitive function was assessed by the Mini-Mental State Examination and the Trail-Making Test. High diastolic BP at baseline predicted later impaired cognitive performance, even after excluding men with a previous stroke (n=70). Cross-sectional measurements at age 70 showed that high 24-hour BP, nondipping, insulin resistance, and diabetes all were related to low cognitive function. The relationships between hypertension and cognitive impairment were strongest in untreated men. These data from a general population of healthy elderly men indicate that hypertension and associated metabolic disturbances might be susceptibility factors for cognitive disorders. The findings add support to possibilities of intervention in early stages in cognitive decline, ie, before manifest dementia.