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Puteikis K, Ažukaitis K, Dadurkevičienė D, Simanauskas K, Šileikienė V, Jankauskienė A, Mameniškienė R. Primary Arterial Hypertension Associated with Cognitive Dysfunction in Young Adults: Results from a Cross-Sectional Controlled Study. Behav Sci (Basel) 2024; 14:321. [PMID: 38667117 PMCID: PMC11047524 DOI: 10.3390/bs14040321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/04/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Despite evidence of primary hypertension (PH)-associated cognitive dysfunction in pediatric, middle-aged, and older adult populations, respective data in young adults remains scarce. We aimed to define differences in cognitive performance between individuals with PH and healthy controls in early adulthood. A convenience sample of young adults (age 18-45 years) with PH and their healthy sex, age, education, and household income matched counterparts were cross-sectionally tested for verbal fluency, verbal memory, general intelligence, reaction speed, attention, visual memory, and executive functioning. Between-group differences were determined using Student's t and Mann-Whitney U tests. Sensitivity analysis was performed by adjusting for body mass index (BMI) in analysis of covariance (ANCOVA) and regression models. Thirty-three adults with PH (22, 66.7% male, median age 38.8, interquartile range (IQR) = 33.2-41.6 years) and twenty-two healthy controls (9, 40.9% male, median age 36.1, IQR = 27.5-39.8 years) completed the neuropsychological assessment. Participants with PH performed worse on computerized tasks of reaction time (median response time (Z = -2.019, p = 0.044), median time for release of response button (Z = -2.509, p = 0.012)) and sustained attention (signal detection measure, RVPA (t = 2.373, p = 0.021), false alarms ÷ (false alarms + correct rejections), RVPPFA (Z = -2.052, p = 0.040)). The group variable was not a statistically significant predictor of performance in these domains after adjustment for BMI (p > 0.05). In regression analyses, high office systolic blood pressure (oSBP) was independently associated with poor sustained attention (βSBP(st.) = -0.283, multiple R2 = 0.252 (RVPA), βSBP(st.) = 0.551, multiple R2 = 0.386 (RVPPFA)). Young adults with PH were found to perform worse in tasks of response speed and sustained attention. While the difference between neuropsychological evaluation results in PH and control groups was confounded by BMI, oSBP measures were independently related to sustained attention. The selectivity of PH-associated cognitive profile in young adults has to be confirmed in larger trials.
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Affiliation(s)
- Kristijonas Puteikis
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Karolis Ažukaitis
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | | | - Kazys Simanauskas
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Vaida Šileikienė
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Augustina Jankauskienė
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
| | - Rūta Mameniškienė
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, Lithuania
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Rensma SP, van Sloten TT, Houben AJ, Köhler S, van Boxtel MP, Berendschot TT, Jansen JF, Verhey FR, Kroon AA, Koster A, Backes WH, Schaper N, Dinant GJ, Schalkwijk CG, Henry RM, Wolfs EM, van Heumen MJ, Schram MT, Stehouwer CD. Microvascular Dysfunction Is Associated With Worse Cognitive Performance. Hypertension 2020; 75:237-245. [DOI: 10.1161/hypertensionaha.119.13023] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Microvascular dysfunction may be associated with worse cognitive performance. Most previous studies did not adjust for important confounders, evaluated only individual measures of microvascular dysfunction, and showed inconsistent results. We evaluated the association between a comprehensive set of measures of microvascular dysfunction and cognitive performance in the population-based Maastricht Study. We used cross-sectional data including 3011 participants (age 59.5±8.2; 48.9% women; 26.5% type 2 diabetes mellitus [oversampled by design]). Measures of microvascular dysfunction included magnetic resonance imaging features of cerebral small vessel disease, plasma biomarkers of microvascular dysfunction, albuminuria, flicker light-induced retinal arteriolar and venular dilation response and heat-induced skin hyperemia. These measures were summarized into a microvascular dysfunction composite score. Cognitive domains assessed were memory, processing speed, and executive function. A cognitive function score was calculated as the sum of the scores on these 3 cognitive domains. The microvascular dysfunction score was associated with a worse cognitive function score (standardized β, −0.087 [95% CI, −0.127 to −0.047]), independent of age, education level, sex, type 2 diabetes mellitus, smoking, alcohol use, hypertension, total/HDL (high-density lipoprotein) cholesterol ratio, triglycerides, lipid-modifying medication, prior cardiovascular disease, depression and plasma biomarkers of low-grade inflammation. The fully adjusted β-coefficient of the association between the microvascular dysfunction score and the cognitive function score was equivalent to 2 (range, 1–3) years of aging for each SD higher microvascular dysfunction score. The microvascular dysfunction score was associated with worse memory and processing speed but not with worse executive function. The present study shows that microvascular dysfunction is associated with worse cognitive performance.
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Affiliation(s)
- Sytze P. Rensma
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Thomas T. van Sloten
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Alfons J.H.M. Houben
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Sebastian Köhler
- MHeNs School for Mental Health and Neuroscience (S.K., M.P.J.v.B., J.F.A.J., F.R.J.V., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Martin P.J. van Boxtel
- MHeNs School for Mental Health and Neuroscience (S.K., M.P.J.v.B., J.F.A.J., F.R.J.V., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Psychiatry and Neuropsychology (M.P.J.v.B., F.R.J.V.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Tos T.J.M. Berendschot
- Department of Ophthalmology (T.T.J.M.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Jacobus F.A. Jansen
- MHeNs School for Mental Health and Neuroscience (S.K., M.P.J.v.B., J.F.A.J., F.R.J.V., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Radiology & Nuclear Medicine (J.F.A.J., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, North Brabant, the Netherlands (J.F.A.J.)
| | - Frans R.J. Verhey
- MHeNs School for Mental Health and Neuroscience (S.K., M.P.J.v.B., J.F.A.J., F.R.J.V., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Psychiatry and Neuropsychology (M.P.J.v.B., F.R.J.V.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Abraham A. Kroon
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Annemarie Koster
- Department of Social Medicine (A.K.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- School for Public Health and Primary Care (CAPHRI) (A.K., N.S., G.-J.D.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Walter H. Backes
- MHeNs School for Mental Health and Neuroscience (S.K., M.P.J.v.B., J.F.A.J., F.R.J.V., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Radiology & Nuclear Medicine (J.F.A.J., W.H.B.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Nicolaas Schaper
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- School for Public Health and Primary Care (CAPHRI) (A.K., N.S., G.-J.D.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Geert-Jan Dinant
- School for Public Health and Primary Care (CAPHRI) (A.K., N.S., G.-J.D.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Casper G. Schalkwijk
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Ronald M.A. Henry
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- The Netherlands Heart and Vascular Center (R.M.A.H., M.T.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Elze M.L. Wolfs
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Mike J.A. van Heumen
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Miranda T. Schram
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- The Netherlands Heart and Vascular Center (R.M.A.H., M.T.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
| | - Coen D.A. Stehouwer
- From the CARIM School for Cardiovascular Diseases (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., R.M.A.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
- Department of Internal Medicine (S.P.R., T.T.v.S., A.J.H.M.H., A.A.K., N.S., C.G.S., R.M.A.H., E.M.L.W., M.J.A.v.H., M.T.S., C.D.A.S.), Maastricht University Medical Center+, Maastricht, Limburg, the Netherlands
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