Vol. 11 nº 4 - Oct/Nov/Dec de 2017
Original Article Páginas: 389 a 397

Impact of hypertension severity on arterial stiffness, cerebral vasoreactivity, and cognitive performance

Authors Henrique Cotchi Simbo Muela1,2; Valeria A. Costa-Hong1; Monica Sanches Yassuda3; Michel Ferreira Machado4; Ricardo de Carvalho Nogueira5; Natalia C. Moraes5; Claudia Maia Memória5; Thiago A. Macedo1; Edson Bor-Seng-Shu5; Ayrton Roberto Massaro5; Ricardo Nitrini5; Luiz A. Bortolotto1


keywords: hypertension; vascular changes; arterial stiffness; cerebral blood flow; cognitive performance.

OBJECTIVE: To evaluate whether arterial stiffness (AS) is related to cerebral blood flow changes and its association with cognitive function in patients with hypertension.
METHODS: 211 patients (69 normotensive and 142 hypertensive) were included. Patients with hypertension were divided into 2 stages: HTN stage-1 and HTN stage-2. The mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA) and a battery of neuropsychological (NPE) tests were used to determine cognitive function. Pulse wave velocity was measured using the Complior®. Carotid properties were assessed by radiofrequency ultrasound. Central arterial pressure and augmentation index were obtained using applanation tonometry. Middle cerebral artery flow velocity was measured by transcranial Doppler ultrasonography.
RESULTS: Both arterial stiffness parameters and cerebral vasoreactivity worsened in line with HTN severity. There was a negative correlation between breath holding index (BHI) and arterial stiffness parameters. Cognitive performance worsened in line with HTN severity, with statistical difference occurring mainly between the HTN-2 and normotension groups on both the MMSE and MoCA. The same tendency was observed on the NPE tests.
CONCLUSION: Hypertension severity was associated with higher AS, worse BHI, and lower cognitive performance.


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