Associação entre parâmetros hemodinâmicos e comprometimento cognitivo em indivíduos hipertensos com risco cardiovascular intermediário e alto

Abstract

The demographic structure in Brazil has changed in recent decades with an increased amount of elderly and a consequent increase in the prevalence of chronic-degenerative diseases such as cardiovascular diseases and diseases related to cognitive decline. Cognitive impairment and dementia are multifactorial injuries, and the role of cardiovascular risk factors are recognized. Several studies link vascular disease, high blood pressure and arterial stiffness to an increased risk of developing cognitive dysfunction. This cross-sectional study was carried out at the Clínica de Hipertensão Arterial e Doenças Metabólicas Associadas (CHAMA), at the Hospital Universitário Pedro Ernesto (HUPE). Patients aged between 40 and 65 years old with previous diagnostic of Primary Arterial Hypertension were included. Three visits were carried out: the first for screening for inclusion and exclusion criteria, signing the informed consent form, and clinical and laboratory evaluation. Subsequently, they were allocated into two groups according to their Cardiovascular Risk Score – low risk and intermediate/high risk. Patients then returned on the second visit for assessment of the heart rate variability, measurement of pulse wave velocity, carotid ultrasound. Later on the third and last visit they proceeded the application of cognitive tests. This study was justified by the need for further studies on the association between hemodynamic and autonomic changes arising from cardiovascular risk factors and the cognitive decline in young populations. A total of 52 patients were recruited of which 40 met the criteria and completed the study, and 22 were classified as low risk and 18 as intermediate/high risk. After analyzing the data there was a significant difference between the groups for pulse wave velocity and vascular age, and a correlation between the similarities test and the Aix – an indirect measure that reflects arterial stiffness. For other hemodynamic or autonomic parameters and cognitive tests there was no statistically significant difference between the groups. Given all data evaluated, it is not possible to assess whether there is a relationship between hypertension, cardiovascular risk and cognition for the different subgroups in the population of adults aged 40 to 65 years.