Aortic reservoir-excess pressure parameters are associated with worse cognitive function in people with untreated stage II/III hypertension.

Autor:	Aizawa K; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Jordan AN; Department of Clinical and Biomedical Sciences.; University Hospitals Dorset, Poole.; NIHR Exeter Clinical Research Facility, Exeter., Gooding KM; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Llewellyn DJ; Department of Health and Community Sciences, University of Exeter Medical School, Exeter.; Alan Turing Institute, London., Mawson DM; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Casanova F; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Gates PE; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Adingupu DD; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Elyas S; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter.; Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust., Hope SV; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter.; Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust., Gilchrist M; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter., Strain WD; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter.; Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust., Clark CE; Department of Health and Community Sciences, University of Exeter Medical School, Exeter., Bellenger NG; Department of Cardiology, Royal Devon University Healthcare NHS Foundation Trust, Exeter., Sharp ASP; University Hospital of Wales, Cardiff., Parker KH; Department of Bioengineering, Imperial College., Hughes AD; MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, UK., Shore AC; Department of Clinical and Biomedical Sciences.; NIHR Exeter Clinical Research Facility, Exeter.
Jazyk:	angličtina
Zdroj:	Journal of hypertension [J Hypertens] 2024 Dec 01; Vol. 42 (12), pp. 2139-2147. Date of Electronic Publication: 2024 Aug 29.
DOI:	10.1097/HJH.0000000000003853
Abstrakt:	Objective: Hypertension is a recognized risk factor for the development of cognitive impairment and dementia in older adults. Aortic stiffness and altered haemodynamics could promote the transmission of detrimental high pressure pulsatility into the cerebral circulation, potentially damaging brain microvasculature and leading to cognitive impairment. We determined whether reservoir-excess pressure parameters were associated with cognitive function in people with hypertension (HT) and normotension (NT). Methods: We studied 35 middle-aged and older treatment-naïve stage II/III HT (office systolic BP 176 ± 17 mmHg) and 35 age-, sex- and body mass index-matched NT (office systolic BP 127 ± 8 mmHg). Parameters derived from reservoir-excess pressure analysis including reservoir pressure integral (INTPR), excess pressure integral (INTXSP), systolic rate constant (SRC), diastolic rate constant (DRC) and pulse wave velocity (PWV) were calculated from an ensemble-averaged aortic pressure waveform derived from radial artery tonometry. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R), Trail Making Test Part A (TMT-A) and Part B (TMT-B). Results: All reservoir-excess pressure parameters were greater in HT than NT (all P  < 0.05). Greater INTXSP was associated with lower ACE-R score ( rs  = -0.31), longer TMT-A ( r  = 0.31) and TMT-B ( r  = 0.38). Likewise, greater DRC and PWV were also associated with lower ACE-R score ( rs  = -0.27 and rs  = -0.33), longer TMT-A ( r  = 0.51 and r  = 0.40) and TMT-B ( r  = 0.38 and r  = 0.32). Greater INTXSP, DRC and PWV are consistently associated with worse cognitive function in this study. Conclusions: These observations support a potential mechanistic link between adverse haemodynamics and a heightened risk of cognitive impairment in older adults with hypertension. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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