Treatment of Hypertension Could Slow Cognitive Decline In Elderly

Results of a recent study are suggesting that treatment of high blood pressure in individuals with hypertension could slow cognitive decline in middle-aged and older adults.

The study, which was presented at the American Heart Association’s Hypertension 2019 Scientific Sessions, revealed older patients who had high blood pressure showed a more rapid rate of cognitive decline but antihypertensive treatment could slow the rate of decline.

“We think efforts should be made to expand high blood pressure screenings, especially for at-risk populations, because so many people are not aware that they have high blood pressure that should be treated," said study investigator Shumin Rui, a biostatistician at the Mailman School of Public Health, Columbia University in New York.

To assess the impact of hypertension and its treatment on cognitive function, investigators carried out an observational study using data from the China Health and Retirement Longitudinal Study (CHARLS). Using CHARLS, investigators identified 10,958 middle-aged and elderly Chinese participants that were followed for 4 years.

Investigators defined high blood pressure as heaving a systolic blood pressure of 140 mmHg or higher and a diastolic blood pressure of 90 mmHg or higher, and/or taking antihypertensive medications. Investigators noted this differs from the American Heart Association’s guidelines, which defines high blood pressure as a systolic reading of 130 mmHg or higher or a diastolic reading of 80 mmHg or more.

Cognition of participants was estimated by a composite score of the Telephone Interview of Cognition Status (TICS) and the immediate and delayed recall of 10 nouns. TICS scores ranged from 0 to 11 and score on the recall assessments ranged from 0 to 10.

Linear regression models were used to examine the relationships between hypertension status, treatment, and cognitive decline over time in different age groups adjusting for baseline cognition scores. Investigators noted further assessments were performed to determine the role of selected covariates, which included gender, education level, and area of residency (rural or urban), related to hypertension and cognition.

Upon analysis, overall cognition scores had declined significantly from 11.01 (SD: 3.96) in 2011 to 10.24 (SD: 4.29) in in 2015. In a cohort of patients 55 years of age or older, investigators found the cognition of hypertensive patient who were unaware of condition showed a 0.57 (P<0.01) point larger decline compared to those without hypertension.

Additionally, patients on antihypertensive treatment were observed to have a 0.56 point smaller cognition decline (P<0.01) compared to patients who were not aware of their condition. Cognition decline of patients on antihypertensive treatment was comparable to the decline among non-hypertensive participants (difference: -0.01 P=96).

Investigators noted that results were similar after adjustments for education, residency and gender. No differences in cognition decline were noted when comparing groups including participants from the ages of 45 to 54.

This study, “Antihypertensive Treatment Stops Cognition Decline in Elderly Chinese With Hypertension,” was presented at the American Heart Association’s Hypertension 2019 Scientific Sessions.