To assess and compare cognitive levels and profiles of five cognitive functions according to hypertensive and heart failure status.
111 hypertensive patients (24h-Ambulatory Blood Pressure Monitoring: day-systolic BP >135mmHg, day-diastolic BP >85mmHg, night-systolic BP > 120mmHg or night-diastolic BP > 70mmHg), 56 normotensive patients and 51 stable heart failure patients (Left Ventricular Ejection Fraction <45 %) all French speaking and without previously known dementia, depression (Beck Depression Inventory >21) or recent stroke, underwent a computerized cognitive test: the CogRT-Kit. This new neuropsychological test evaluates globally and specifically 5 cognitive functions (visuospatial abilities, language, executive functions, recent and delayed memory) with the same paradigm. Therefore this test enhances comparison between functions to determine a cognitive profile. Comparison between function in profile used the Student t-test.
Heart failure was significantly associated with global cognition (β=−0.65, p=0.04, R2=0.27), language, (β=−0.56, p=0.002, R2=0.26) executive functions (β=−0.96, p=0.007, R2=0.34) recent (β=−0.75, p<0.001, R2=0.33) and delayed memory (β=−0.95, p=0.001, R2=0.22) in multivariate analysis after adjustment on age, gender, years of education and hypertension.
A subgroup analysis on 60-75 years old patients, 41 hypertensive, 19 heart failure and 33 normotensive patients matched on age, years of education and gender, was performed. No significant difference on depression index, exposure to anxiolytics/hypnotics, sleep-apnea syndrome and other cardiovascular risk factors was observed. The cognitive profile (Fig 1) shows significant level differences between functions in heart failure compared to normotensive (normalized) with significant deficits in executive functions (p<0.01) and delayed memory (p<0.02), while cognitive functions are affected with the same level in hypertension except for recent memory.
We confirm that heart failure is an independent predictor of cognitive impairment, and affects more specifically language, executive functions, recent and delayed memory. Hypertension slightly impairs cognitive functions with the same level.Le texte complet de cet article est disponible en PDF.