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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 Americans, 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