January 04, 2019
1 min read

Hypertension, white matter hyperintensities confer cognitive risk

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Patients with hypertension and progression of periventricular white matter abnormalities were at elevated risk for cognitive impairment, according to new findings.

Joan Jiménez-Balado, MSc, a PhD student at Neurovascular Research Lab, Vall d’Hebron Research Institute, Universitat Autònoma de Barcelona, Spain, and colleagues analyzed 345 patients with hypertension (median age, 65 years; 55% men) from the Investigating Silent Strokes in Hypertensives: a magnetic resonance imaging study (ISSYS) cohort without stroke or dementia at baseline.

At baseline and follow-up (mean, 3.95 years), all patients underwent a brain MRI, a cognitive screening test and a cognitive diagnosis to determine changes in cerebral small vessel disease lesions related to cognitive decline and incident mild cognitive impairment.

The researchers observed mild cognitive impairment in 9.1% of the cohort and determined the following prevalence rates: incident infarcts, 6.1%; incident cerebral microbleeds, 5.5%; progression of periventricular white matter hyperintensities, 22%; and progression of deep white matter hyperintensities, 48%.

Compared with patients without progression of periventricular white matter hyperintensities, those with it had elevated risks for reduced global cognition (patients with progression: adjusted mean, –0.519; standard error, 0.176; patients without progression: adjusted mean, 0.057; standard error, 0.044; P = .004) and mild cognitive impairment (OR = 6.184; 95% CI, 1.506-25.37), according to the researchers.

“In this sample of patients with hypertension, we observed associations of marked [periventricular white matter hyperintensities] progression with cognitive decline and incident [mild cognitive impairment]. As [mild cognitive impairment] is one of the most important risk factors in the development of dementia, future research should investigate the mechanisms by which [periventricular white matter hyperintensities] trigger cognitive impairment and the clinical utility of its assessment,” Jiménez-Balado and colleagues wrote. – by Erik Swain

Disclosures: The authors report no relevant financial disclosures.