Is hypertension linked with gait, mood, and cognitive impairment?

January 01, 0001

Is hypertension linked with gait, mood, and cognitive impairment?

These US and Spanish researchers examined whether hypertension was associated with impairments in mobility, cognition, and mood. White matter lesions are a possible candidate for mediating any such association. They looked at 4700 enrollees from the Cardiovascular Health Study, documenting blood pressure, gait, digit symbol substitution test results, and the Center for Epidemiological Studies Depression Scale and compared to MRI results of the brain (though only 3600 had imaging).

The researchers report: "Using latent profile analysis at baseline, we found that 498 (11%) subjects had concurrent impairments and 3086 (66%) were intact on all 3 measures. Between 1992 and 1999, 651 (21%) became impaired in all 3 domains. Hypertensive individuals were more likely to be impaired at baseline (odds ratio 1.23) and become impaired during the follow- up (hazard ratio=1.3). A greater degree of white matter hyperintensities was associated with impairments in the 3 domains and mediated the association with hypertension (21% hazard ratio change). Impairments in the 3 domains increased subsequent disability with hypertension. Hypertension mortality also was increased in those impaired (compared with unimpaired hypertensive individuals HR=1.10)."

The researchers concluded: "Hypertension increases the risk of concurrent impairments in mobility, cognition, and mood, which increases disability and mortality. This association is mediated in part by microvascular brain injury."

Hypertension is linked with impairments in mood, cognition and mobility.

For the full abstract, click here.

Circulation 123:833-834, 1 March 2011
© 2011 American Heart Association, Inc.
Hypertension, White Matter Hyperintensities, and Concurrent Impairments in Mobility, Cognition, and Mood-The Cardiovascular Health Study. Ihab Hajjar, Lien Quach, Frances Yang, et al. Correspondence to Ihab Hajjar:

Category: K. Circulatory, N. Neurological. Keywords: hypertension, gait, mood, cognition, white matter hyperintensities, epidemiological study, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 29 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.