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Blood pressure and cognitive performances in middle-aged adults

the Aging, Health and Work longitudinal study

Rouch, Laurea,b,c; Cestac, Philippea,b,c; Hanon, Olivierd,e; Ruidavets, Jean-Bernarda,f; Ehlinger, Virginief; Gentil, Catherinef; Cool, Charlènea,b,c; Helmer, Catherineg,h; Dartigues, Jean-Françoisg,h; Bouhanick, Béatricea,b,i; Chamontin, Bernarda,b,i; Sallerin, Brigitteb,c,j; Vellas, Brunoa,b,k; Marquié, Jean-Claudel; Esquirol, Yolandea,b,m; Andrieu, Sandrinea,b,f

doi: 10.1097/HJH.0000000000002013
ORIGINAL PAPERS: Epidemiology
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Background: Our objective was to investigate the impact of both prevalent and incident hypertension on cognition in middle-aged individuals followed up for 10 years and to explore the extent to which blood pressure control by antihypertensive drugs could modify this relationship.

Method: Three thousand, two hundred and one participants from the Vieillissement Santé Travail (Aging, Health and Work) (VISAT) cohort study, aged 32, 42, 52 and 62 years at baseline were followed up 5 and 10 years later. Blood pressure, antihypertensive medication use as well as memory and speed cognitive performances were assessed at baseline and follow-up. Linear mixed models were used for analyses.

Results: At 10-year follow-up, compared with nonhypertensive participants, prevalent hypertensive individuals showed poorer global cognitive performances (β = −2.99 ± 0.96, P = 0.002 for participants aged 32 or 42 years at baseline and β = −5.94 ± 1.00, P < 0.001 for those aged 52 or 62). Patients with incident hypertension had poorer global cognitive performances over time compared with patients without hypertension. When considering prevalent hypertension and blood pressure control status by antihypertensive therapy, untreated and uncontrolled hypertension were associated with poorer cognitive performances than controlled and no hypertension (untreated hypertension compared with no hypertension: β = −5.51 ± 0.75, P < 0.001; uncontrolled hypertension compared with no hypertension: β = −6.13 ± 1.40, P < 0.001).

Conclusion: Our findings showed that both prevalent and incident hypertension are associated with poorer global cognitive function in middle-aged individuals and suggested a potential preventive effect of antihypertensive therapy on cognition. Thus, for brain functioning, heightened efforts to detect hypertension and adequately treat it are of critical importance.

aINSERM 1027

bUniversity Paul Sabatier, Toulouse

cToulouse University Hospital, Department of Pharmacy

dUniversity Paris Descartes

eBroca Hospital, Department of geriatric medicine, Paris

fToulouse University Hospital, Department of Epidemiology and Public Health

gINSERM 897

hUniversity Bordeaux II, ISPED, Bordeaux

iToulouse University Hospital, Department of Internal Medicine and Hypertension

jINSERM 1048, Toulouse

kToulouse University Hospital, Department of geriatric medicine

lCLLE (UMR 5263), Toulouse University, CNRS, EPHE, UT2J

mToulouse University Hospital, Department of Occupational Medicine, France

Correspondence to Laure Rouch, PharmD, PhD, INSERM 1027 Epidemiology and Public Health, 37, Allées Jules Guesde, 31000 Toulouse, France. Tel: +33 671345123; fax: +33 562264240; e-mail: rouch.l@chu-toulouse.fr

Abbreviations: BP, blood pressure; DSST, digit symbol substitution subtest; PCA, principal component analysis

Received 22 February, 2018

Accepted 7 November, 2018

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