1. 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

2. 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

3. 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

4. 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.

5. 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 vs 28.6 and Montreal Cognitive Assessment 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

6. 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.

7. 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

8. 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