Abstract 9350: Cerebral Perfusion and Cognitive Function in Post-Stroke Patients with Hypertension
Objective: To estimate cerebral perfusion and cognitive function in post-stroke patients with hypertension before and after hypotensive therapy.
Research design and methods: The treatment group comprised 28 post-stroke patients (mean age ± standard deviation [SD], 57.8 ± 8.3 years) with previously untreated or ineffectively treated essential hypertension. All patients underwent brain xenon-enhanced computed tomography (Xe-CT) scanning and comprehensive neuropsychological testing, both before and after 24 weeks of hypotensive therapy using the angiotensin II receptor blocker (ARB) olmesartan medoxomil. The control group comprised 20 age-matched post-stroke patients (mean age ± SD, 56.6 ± 8.5 years) without hypertension, carotid atherosclerosis, coronary artery disease, or psychiatric disorders.
Results: The hypertensive patients had significantly lower levels of cerebral perfusion (4-8%) in all brain regions, a 25% decrease in attention and psychomotor speed, and an 18% decrease in mentation compared with the control subjects. Following 6 months of hypotensive therapy, the hypertensive patients experienced an increase in cerebral perfusion by 8-15% in all brain regions, an 18-36% improvement in attention and psychomotor speed, and an average 19% improvement in abstract mentation.
Conclusions: Hypertensive patients showed marked signs of cerebral hypoperfusion and impaired cognitive function, as indicated by decreased attention, reduced psychomotor speed, and slow mentation; however, these symptoms were improved by 24 weeks of hypotensive treatment with an ARB.
- © 2011 by American Heart Association, Inc.