Finland: People having hypertension onset at an early age (before 35 years of age) are at an increased risk of cognitive impairment during their midlife, finds a recent study in the journal Hypertension. The findings suggest that assessment of age at hypertension onset may improve risk stratification of cognitive decline.
Hypertension is associated with an increased risk of cognitive decline in a highly age-dependent manner. However, there are conflicting evidence on the relation between age of hypertension onset and cognition. Karri Suvila, Turku University Hospital, University of Turku, Finland, and colleagues aimed to investigate the association between early- versus late-onset hypertension and midlife cognitive performance in 2946 participants (mean age 55±4, 57% women) from CARDIA study (Coronary Artery Risk Development in Young Adults).
The participants underwent 9 repeat examinations of blood pressure measurements, between 1985 to 1986 and 2015 to 2016. The participants underwent brain magnetic resonance imaging. They completed Rey Auditory Verbal Learning Test, Digit Symbol Substitution Test, Stroop interference test, and the Montreal Cognitive Assessment for evaluating cognitive function at the year 30 exam.
The researchers assessed the association between age of hypertension onset and cognitive function using linear regression models adjusted for cognitive decline risk factors, including systolic blood pressure.
Key findings of the study include:
The researchers observed that individuals with early-onset hypertension (onset at <35 years) had 0.24±0.09, 0.22±0.10, 0.27±0.09, and 0.19±0.07 lower standardized Z-scores in Digit Symbol Substitution Test, Stroop test, Montreal Cognitive Assessment, and a composite cognitive score than participants without hypertension.
In contrast, hypertension onset at ≥35 years was not associated with cognitive function.
In a subgroup of 559 participants, neither early- nor late-onset hypertension was related to macrostructural brain alterations.
"Our results indicate that early-onset hypertension is a potent risk factor for midlife cognitive impairment. Thus, age of hypertension onset assessment in clinical practice could improve risk stratification of cognitive decline in patients with hypertension," concluded the authors.
The study titled, "Early-but Not Late-Onset Hypertension Is Related to Midlife Cognitive Function," is published in the journal Hypertension.
DOI: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16556