From ESH 2016 | POS 3C: Luiz Aparecido Bortolotto, MD, PhD

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Arterial Alterations Contributed to Reduced Cognitive Function in Hypertension From ESH 2016 | POS 3C: Luiz Aparecido Bortolotto, MD, PhD Heart Institute, University of São Paulo, Brazil

Overview Observational study of global and domain-specific cognitive function and the correlation between cognitive performance and arterial properties in Stage 1 to 3 hypertension vs normotension Cognitive impairment was more frequent in adults with than without arterial hypertension Arterial alterations contributed to reduced domain- specific cognitive function

Study Population 162 adults; of 120 adults with hypertension, 40% had Stage 2, 30% Stage 1, 30% Stage 3 Exclusion criteria were current smoking, diabetes, arrhythmia, ventricular dysfunction, and neurodegenerative disease Hypertension group significantly older, fewer were white, shorter duration of education, higher levels of systolic and diastolic blood pressure

Baseline Characteristics in Study Patients Variable Study groups p value Control (42) HTN (120) Age, mean (SD) 44.74(11.42) 51.07(11.05) 0.003 Sex, Male No (%) 29 (69) 55 (45.8) 0.636 Race, white, No (%) 37(88.1) 83 (69.2) <0.001 BMI (kg/m2) 26.98(3.96) 29.74(4.63) 0.238 Education, mean (SD) y 14.88(4.06) 9.99(4.43) SBP, mean (SD) mmHg 121.90(7.15) 141,45(23,48) DBP, mean (SD) mmHg 76.12(6.95) 87,28(13,42) BMI, body mass index; DBP, diastolic blood pressure; SBP, systolic blood pressure.

Results Some arterial parameters significantly higher in hypertension vs control, adjusted for age and difference in blood pressure Carotid artery diameter, mean pulse wave velocity, mean augmentation index, mean central SBP, mean central DBP Scores for global cognitive status significantly lower in hypertension vs control, adjusted for age and duration of education Mini Mental Status Examination 26.97 vs 28.6 and Montreal Cognitive Assessment 23.86 vs 26.7 (p<0.01 for both) Each of 5 cognitive function domains significantly lower in hypertension vs control, adjusted for age and duration of education

Cognitive Function in Five Domains by Study Group Variable Study groups p value Control (42) HTN (125) Language 86,18±6 68,03±5 <0.01 Memory 62.91±4 56.21±4 Executive Functions (time, s) 192±26 332±54 <0.05 Spatial and visual perception 38.58±3 34.83±4 Concentration 78.05±7 56.23±7 HTN, hypertension.

Correlation of Arterial Properties and Cognitive Outcomes Significant inverse relation found between augmentation index and global cognitive tests, adjusted for age and duration of education Augmentation index correlated with executive function, language, visual spatial perception, concentration Pulse wave velocity correlated with executive function, memory, concentration Carotid diameter correlated with executive function, visual spatial perception Causal relation between arterial alterations and cognitive performance could not be established in this study

Arterial Alterations Contributed to Reduced Cognitive Function in Hypertension From ESH 2016 | POS 3C: Luiz Aparecido Bortolotto, MD, PhD Heart Institute, University of São Paulo, Brazil