Assessment of cognitive impairment in Tunisian hypertensive patients

Abstract

Background: The prevention of cognitive impairment is a major public health issue. Several international studies have shown a significant association between arterial hypertension (AH) and cognitive decline, highlighting the role of AH as a risk factor for dementia. Our aim was to evaluate cognitive impairment in hypertensive patients. Material and methods: We conducted a descriptive, prospective, multicenter study involving patients over 40 years old with confirmed essential hypertension for more than 3 years. All participants underwent neuropsychological assessment using three tests exploring cognitive function: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Memory and Executive Screening (MES). Then, we divided our population into two groups: a group with cognitive decline defined by an MMSE score < 24 and no cognitive decline. Results: We included 200 patients with a mean age of 65 ± 9 years and a gender ratio of 0.78. Assessment of cognitive performance revealed a cognitive decline in 42.5% of patients (n = 85) by MMSE, 73.5% of cases (n = 147) by MoCA, and 82.5% of cases (n = 165) by MES. The four factors independently predictive of cognitive decline were: age [odds ratio (OR) adjusted: 10.6, 95% confidence interval (CI): 4.38–23.57], p < 0.001), female sex (OR adjusted: 7.81, 95% CI: 3.15–19.29, p < 0.001), sedentary lifestyle (OR adjusted: 2,52, 95% CI: 1.09–5.86, p = 0.031) and poor blood pressure (BP) control (OR adjusted: 3.33, 95% CI: 1.35–5.86, p = 0.009). Conclusion: Our study showed that cognitive impairment was frequent in hypertensive patients. Screening should be carried out to implement an appropriate therapeutic strategy.