COGNITIVE IMPAIRMENT AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH RESISTANCE HYPERTENSION.

OBJECTIVE: To determine predictors of cognitive impairment in patients with resistance hypertensin (RH) after 3-years of follow-up.

DESIGN AND METHOD: In 98 patients with RH (average age 52.4 ± 1.2, 60 males, mean hypertension history at the baseline 12.8 ± 0.9 years) we measured office blood pressure, ultrasonographically diameter (D) of common carotid (CCA) artery, carotid intima-media thickness (IMT), performed Montreal cognitive assessment (MoCA) test, ambulatory blood pressure monitoring twice: initially and after a mean period of 3 years. Also morning fasting venous blood samples were obtained from all subjects for uric acid, lipid profile, glucose assays. Age and other cardiovascular risk factors were included in the analysis.

RESULTS: There was a significant deterioration in the MoCA results during the follow-up: 23.2 ± 0.2 at the baseline vs 22.6 ± 0.2 after 3 years, p = 0,02. The cognitive decline was significantly associated with initial measurement of IMT (b = -0.232, p = 0.01). This association was independent of age, body mass index and hypertension history. No statistically significant associations were obtained between the MoCA results and systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, LDL cholesterol, serum uric acid, glucose.

CONCLUSIONS: Our data suggested that cognitive impairment in patients with resistance hypertension associated with severity of the carotid structure damage and carotid intima-media thickness at the baseline was independent predictor of cognitive decline in these patients.