Document Detail

Cognitive impairment is related to increased arterial stiffness and microvascular damage in patients with never-treated essential hypertension.
MedLine Citation:
PMID:  19265790     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is known that essential hypertension may be implicated in the development of cognitive impairment that is associated to microvascular disease of the brain. It has been hypothesized that increased arterial stiffness of the large arteries may lead to microvascular changes due to increased pulsatile flow. Our study tests the hypothesis that large artery stiffness and microvascular damage are related to brain microcirculation changes as reflected by impaired cognitive function.
METHODS: We studied 110 nondiabetic patients aged 40-80 years (mean age 53.8 +/- 11.2 years, 57 men) with recently diagnosed stage I-II essential hypertension. Mini-Mental State Examination (MMSE) was used as a screening test for global cognitive impairment. We performed both 2-D echocardiography and carotid-femoral pulse wave velocity (PWV) in order to evaluate arterial stiffness. Twenty-four hour urine microalbumin excretion was measured as a marker of microvascular damage.
RESULTS: In the entire population, MMSE was negatively correlated with age (r = -0.42, P < 0.001), 24-h pulse pressure (PP) (r = -0.18, P < 0.05), and PWV (r = -0.3, P = 0.003). Additionally, MMSE was not independently correlated with microalbuminuria in patients aged over 65 years (r = -0.58, P = 0.003).
CONCLUSIONS: Impaired cognitive function is associated with increased large artery stiffness and microalbumin excretion in newly diagnosed, untreated hypertensive patients. These findings support the hypothesis that cognitive impairment induced by impaired microcirculation is linked to large artery stiffness and microvascular damage.
Helen Triantafyllidi; Chrysa Arvaniti; John Lekakis; Ignatios Ikonomidis; Nikolaos Siafakas; Stavros Tzortzis; Paraskevi Trivilou; Loukia Zerva; Eleftherios Stamboulis; Dimitrios Th Kremastinos
Publication Detail:
Type:  Journal Article     Date:  2009-03-05
Journal Detail:
Title:  American journal of hypertension     Volume:  22     ISSN:  1941-7225     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-23     Completed Date:  2009-05-28     Revised Date:  2011-06-30    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  525-30     Citation Subset:  IM    
2nd Department of Cardiology, Medical School, University of Athens, Attikon Hospital, Athens, Greece.
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MeSH Terms
Aged, 80 and over
Albuminuria / physiopathology
Arteries / physiology
Blood Pressure
Cognition Disorders / etiology*
Elasticity / physiology
Hypertension / complications,  physiopathology*
Middle Aged
Vascular Resistance / physiology
Comment In:
Am J Hypertens. 2009 Aug;22(8):814; author reply 815   [PMID:  19638951 ]
Am J Hypertens. 2009 May;22(5):469   [PMID:  19387429 ]

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