A study on relationship between hypertension and cognitive performance

Hypertension is a major public health problem in India with a prevalence ranging between 20–40%. Chronically sustained high blood pressure is associated with a number of adverse health effects such as myocardial infarction, renal failure, stroke and may also lead to cognitive decline. The relationship between blood pressure and cognition has varied across studies; hence this study was taken up to evaluate the relationship between hypertension and cognitive performance.

Hypertension is associated with cognitive decline.

Study involved 30 hypertensive and 30 normotensive subjects. Hypertension was diagnosed based on JNC VII criteria. Both groups were matched for age and education. Potential alternative psychosocial causes of cognitive impairment such as depression, anxiety, stress were ruled out using DASS21. In both groups, cognitive functions in domains of psychomotor speed, sustained attention, executive functions, short and long term verbal memory were assessed using a battery of performance tests. Results were compiled and statically analyzed using Pearson's Chi-square test, student-t test, odds ratio on SPSS software version 17.

A significant association was found between hypertension and psychomotor speed (p= <0.01), sustained attention (p= <0.01), short term and long term verbal memory (p= <0.05). No association was observed between hypertension and executive functions.

Hypertensives performed poor in set of tasks that measure psychomotor speed, sustained attention, short and long term verbal memory probably because hypertension brings certain pathophysiological changes in brain such as vascular remodelling, impaired cerebral auto regulation, small lacunar infarcts, white matter lesion and amyloid angiopathy. Thus it is imperative to strictly control blood pressure in hypertensives to avoid deleterious effect of hypertension on cognition.