Hypertension, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (SOL-INCA).

BACKGROUND Hypertension can have deleterious effects on cognitive function; however, few studies have examined its effects on cognition among Hispanics/Latinos. OBJECTIVE To assess associations between hypertension status with 1) change in cognitive performance, and 2) having mild cognitive impairment (MCI) among diverse Hispanics/Latinos. METHODS This population-based, prospective cohort, multisite study included Hispanic/Latino adults aged 45 to 72 years in enrolled in the Hispanic Community Health Study/Study of Latinos at Visit 1 (2008-2011; mean age of 63.40±8.24 years), and the Study of Latinos-Investigation of Neurocognitive Aging at Visit 2 (2016-2018), with a mean follow-up duration of 7 years (n = 6,173). Hypertension status was assessed at both visits: normotension (no hypertension), incident hypertension (only at Visit 2), and persistent hypertension (at both visits). We examined change in cognitive performance and having MCI (only assessed at Visit 2) relative to hypertension status and adjusted for demographics and cardiovascular disease risk factors. RESULTS Compared to normotension, persistent hypertension was associated with significantly increased decline in verbal fluency (β= -0.08; CI = [-0.16;-0.01]; p < 0.05), and processing speed (β= -0.11; CI = [-0.20;-0.02]; p < 0.05). Incident hypertension was not associated with significant change in cognitive performance. Both incident (OR = 1.70; CI = [1.16;2.50]; p < 0.01) and persistent hypertension (OR = 2.13; CI = [1.57;2.88]; p < 0.001) were associated with significantly higher odds ratios of having MCI. CONCLUSIONS These findings indicate that persistent hypertension is associated with clinical impairment and domain-specific cognitive decline in middle-aged and older Hispanics/Latinos. It underscores the importance of monitoring blood pressure in routine healthcare visits beginning at midlife in this population to reduce the burden of cognitive decline.

背景 高血压会对认知功能产生有害影响；然而，很少有研究探讨其对西班牙裔/拉丁裔人群认知的影响。 目的 评估高血压状况与以下两者之间的关联：1）认知表现的变化，以及2）不同西班牙裔/拉丁裔人群中轻度认知障碍（MCI）的患病情况。 方法 这项基于人群的前瞻性队列、多地点研究纳入了在第1次随访（2008 - 2011年；平均年龄63.40±8.24岁）时参与西班牙裔社区健康研究/拉丁裔研究的45至72岁的西班牙裔/拉丁裔成年人，以及在第2次随访（2016 - 2018年）时参与拉丁裔神经认知衰老研究的人员，平均随访时间为7年（n = 6173）。在两次随访中均评估了高血压状况：正常血压（无高血压）、偶发性高血压（仅在第2次随访时出现）和持续性高血压（在两次随访时均存在）。我们研究了认知表现的变化以及轻度认知障碍（仅在第2次随访时评估）与高血压状况的关系，并根据人口统计学特征和心血管疾病危险因素进行了调整。 结果 与正常血压相比，持续性高血压与语言流畅性（β = -0.08；置信区间 = [-0.16；-0.01]；p < 0.05）和处理速度（β = -0.11；置信区间 = [-0.20；-0.02]；p < 0.05）的显著下降相关。偶发性高血压与认知表现的显著变化无关。偶发性（优势比 = 1.70；置信区间 = [1.16；2.50]；p < 0.01）和持续性高血压（优势比 = 2.13；置信区间 = [1.57；2.88]；p < 0.001）均与患轻度认知障碍的较高优势比显著相关。 结论 这些研究结果表明，在中年和老年西班牙裔/拉丁裔人群中，持续性高血压与临床损伤和特定领域的认知下降有关。这强调了在该人群中年时期开始的常规医疗就诊中监测血压的重要性，以减轻认知下降的负担。