Abstract 10959: Left Ventricular Hypertrophy is a Useful Predictor of Cognitive Impairment Independently of 24-Hour and Nighttime Blood Pressure Levels in Middle-aged and Older Hypertensive Patients
Background and Objective Along with the increasing longevity of humans worldwide, early identification of older subjects who are likely to develop cognitive impairment and the prevention of its progression haves become major public health challenges. Hypertension is major risk factor for cognitive impairment, and individuals with high 24-hour blood pressure (BP), particularly, nocturnal BP, are likely to develop cognitive impairment. Moreover, a recent study showed that left ventricular hypertrophy (LVH) is a useful predictor of cognitive impairment in older people. However, this association has never been examined in relation to 24-hour or nighttime BP level.
Methods: We recruited 588 ambulatory hypertensive patients who were>40 years (mean 73years; 41% men). They were cross-sectionally examined for 24-hour BP and left ventricular mass index (LVMI), and were given the Mini-Mental State Examination (MMSE).
Results: There were significant associations of MMSE with LVMI (R=-0.328; P<0.001), 24-hour systolic BP (R=-0.17; P<0.001) or nighttime systolic BP (R=-0.21; P<0.001). The association between MMSE and LVMI remained significant even after adjustment for significant covariates including 24-hour and nighttime systolic BP levels (β=-0.02; P<0.001). When our patients were subdivided into tertiles according to LVMI, there was a gradual decrease in MMSE score from the first to third tertile groups (mean MMSE score; 26.8vs. 26.3 vs. 25.4), P<0.001 for linear trend). Furthermore, a multivariate logistic regression analysis to calculate the hazard ratio (HR) (95%CI) of the lowest tertile of MMSE score (mean MMSE: 22.8, n=184) revealed that each LVH (defined as LVMI; men≥125 kg/m2, women≥110 kg/m2, n=329 ) and elevated 24-hour or nighttime systolic BP showed an independently significant increased risk of low MMSE score ( all P <0.05).
Conclusion: In addition to 24-hour and nighttime BP levels, the presence of LVH is a useful predictor of cognitive impairment in middle-aged and older hypertensive patients.
- © 2011 by American Heart Association, Inc.