Values of ambulatory blood pressure monitoring for prediction of cognitive function impairment in elderly hypertensive patients

摘要

BackgroundHypertension has been shown to carry an increased risk not only for cerebrovascular stroke but also for cognitive impairment and dementia. Ambulatory blood pressure monitoring (ABPM) is a good predictor of cardiac, renal, and cerebral disease in middle-aged and older people with hypertension.Patients and methodsThe study included 77 elderly (mean age: 69years) subjects. Based on the history of hypertension, office blood pressure, and ABPM, patients were classified into 2 groups, Group I: 22 persons as a control group and Group II: 55 hypertensive patients. The hypertensive group was further sub classified by using data of ABPM into dippers and non-dippers. Both groups were subjected to clinical examination, laboratory analysis, ABPM, Transthoracic Echocardiographic Examination, brain magnetic resonance imaging (MRI) and mini-mental state examination (MMSE) of their cognitive function.ResultsThere was a statistically significant positive correlation between the cerebral MRI score and each of the average 24-h systolic, diastolic and mean arterial blood pressure, average morning systolic, diastolic, mean arterial blood pressure, average night systolic, diastolic and mean arterial blood pressure. There was also a statistically significant negative correlation between the MMSE score and the previous parameters. A non significant correlation was noted between the cerebral MRI score and the office systolic and diastolic blood pressure in hypertensive group.ConclusionThe study demonstrated that hypertensive patients diagnosed by ABPM have significantly more impaired cognitive function than control subjects as proved by the mini-mental state examination and brain MRI score of white matter disease.