Values of ambulatory blood pressure monitoring for prediction of cognitive function impairment in elderly hypertensive patients

Background: Hypertension has been shown to carry an increased risk not only for cerebrovascular stroke but also for cognitive impairment and dementia. Ambulatory blood pressure monitoring (ABPM) is a good predictor of cardiac, renal, and cerebral disease in middle-aged and older people with hypertension. Patients and methods: The study included 77 elderly (mean age: 69. years) subjects. Based on the history of hypertension, office blood pressure, and ABPM, patients were classified into 2 groups, Group I: 22 persons as a control group and Group II: 55 hypertensive patients. The hypertensive group was further sub classified by using data of ABPM into dippers and non-dippers. Both groups were subjected to clinical examination, laboratory analysis, ABPM, Transthoracic Echocardiographic Examination, brain magnetic resonance imaging (MRI) and mini-mental state examination (MMSE) of their cognitive function. Results: There was a statistically significant positive correlation between the cerebral MRI score and each of the average 24-h systolic, diastolic and mean arterial blood pressure, average morning systolic, diastolic, mean arterial blood pressure, average night systolic, diastolic and mean arterial blood pressure. There was also a statistically significant negative correlation between the MMSE score and the previous parameters. A non significant correlation was noted between the cerebral MRI score and the office systolic and diastolic blood pressure in hypertensive group. Conclusion: The study demonstrated that hypertensive patients diagnosed by ABPM have significantly more impaired cognitive function than control subjects as proved by the mini-mental state examination and brain MRI score of white matter disease.