Cognitive Performance in Hypertensive and Normotensive Older Subjects

Abstract

Abstract —Longitudinal studies suggest that hypertension in midlife is associated with cognitive impairment in later life. Cross-sectional studies are difficult to interpret because blood pressure can change with onset of dementia and the inclusion of subjects on treatment and with hypertensive end-organ damage can make analysis difficult. We examined cognitive performance in hypertensive and normotensive subjects without dementia or stroke ≥70 years of age. Cognitive performance was determined with the use of a computerized assessment battery in 107 untreated hypertensives (55 women, age 76±4 years, blood pressure, 164±9/89±7; range, 138 to 179/68 to 99 mm Hg) and 116 normotensives (51 female, age 76±4 years, 131±10/74±7; 108 to 149/60 to 89 mm Hg). Older subjects with hypertension were significantly slower in all tests (reaction time, milliseconds; simple, 346±100 versus 318±56, P <0.05; memory scanning, 867±243 versus 789±159, P <0.01; immediate word recognition, 947±261 versus 886±192, P <0.05; and delayed word recognition, 937±230 versus 856±184, P <0.05; picture recognition, 952±184 versus 894±137, P <0.01; spatial memory, 1390±439 versus 1258±394, P <0.01; excepting choice reaction time, 510±75 versus 498±72, P =0.08). Accuracy was also impaired in tests of number vigilance, 99.2±2.5% versus 99.9±0.9, P <0.01; delayed word recognition, 83.5±16 versus 87.9±9.8, P <0.01; and spatial memory 64±32 versus 79±20, P <0.001. Hypertension in older subjects is associated with impaired cognition in a broad range of areas in the absence of clinically evident target organ damage.