Assessment of the relationship between manifestations of cognitive deficit and the indicator of vascular age in patients with arterial hypertension

BACKGROUND. Vascular age is considered as an additional criterion for the progression of cardiovascular disease and cardiovascular aging. Arterial hypertension contributes to the development of cognitive impairments that go beyond the age norm.

OBJECTIVE. Evaluation of the correlation relationship between vascular age and manifestations of moderate cognitive impairment in patients with arterial hypertension.

MATERIALS AND METHODS. The study included 30 patients with stage 1 and 2 arterial hypertension, 12 men, 18 women, aged 67 to 70 years. All patients underwent clinical, laboratory and instrumental examination in accordance with clinical recommendations. Based on the modified SCORE table, vascular age was calculated taking into account gender, age, smoking status, blood pressure and total serum cholesterol levels. The presence of manifestations of moderate cognitive impairment was assessed using the self-assessment questionnaire. A score of more than 45 points allowed us to suspect cognitive impairment. Moderate cognitive impairment was objectively assessed by conducting a minimal neuropsychological study on the ability to remember and repeat words before and after the Clock test.

RESULTS. In all patients, the vascular age was higher than the chronological age. The average chronological age was (62.4 ± 11.6) year, the average vascular age was (68.7 ± 10.6) year. The predominance of vascular age over chronological age varied from 2 to 10 years and was directly proportional to the duration of arterial hypertension (r = 0.64). Cognitive impairment, according to the memory self-assessment test, was detected in 11 patients (36.6 %). The average score of the memory self-assessment test was 38.39. The indicator of this test correlated with the vascular age indicator (r = 0.65). Objective assessment confirmed moderate cognitive impairment in 7 patients (23.3 %). According to the minimal neuropsychological examination, they were unable to reproduce previously memorized words, and 4 of them had noticeable deviations in the position of the hands or numbers on the clock face in the drawing. In these patients, the vascular age exceeded the chronological age by 7–10 years.

CONCLUSION. The obtained results showed that arterial hypertension can lead to the development of cognitive deficit. The influence of risk factors for arterial hypertension, which reflects the vascular age indicator, and an increase in the duration of arterial hypertension is associated with the likelihood of developing mild cognitive impairment.