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Cognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos.

TitleCognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos.
Publication TypePublication
Year2017
AuthorsLamar M, Wu D, Durazo-Arvizu RA, Brickman AM, González HM, Tarraf W, Daviglus ML
JournalAm J Hypertens
Volume30
Issue6
Pagination624-631
Date Published2017 Jun 01
ISSN1941-7225
KeywordsAged, Antihypertensive Agents, blood pressure, Cognition, Cross-Sectional Studies, executive function, Female, Health Knowledge, Attitudes, Practice, Hispanic or Latino, Humans, Hypertension, Linear Models, Male, Middle Aged, Multivariate Analysis, Prospective Studies, Risk Factors, Treatment Outcome, United States
Abstract

BACKGROUND: Hypertension control in Hispanics/Latinos lag behind general US trends by 10-15%. Intensive systolic blood pressure (SBP) management <120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP < 140 mm Hg) and more intensive (SBP < 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos.METHODS: From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45-74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English.RESULTS: Separate linear regressions revealed that being on 1 vs. >1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P < 0.01] and information processing speed [Beta = 3.01 (0.89), P < 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P < 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels <120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P < 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P < 0.05).CONCLUSIONS: Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies.

DOI10.1093/ajh/hpx023
Alternate JournalAm J Hypertens
PubMed ID28402388
PubMed Central IDPMC5861562
Grant ListR01 AG048642 / AG / NIA NIH HHS / United States
K01 AG040192 / AG / NIA NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
MS#: 
0332
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
ECI: 
Manuscript Affiliation: 
Field Center: Chicago (University of Illinois at Chicago)
Manuscript Status: 
Published