Abstract P084: When To Expect And Why To Analyze Cognitive Disorders In Arterial Hypertension

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Viktoriia Krotova ◽  
Tatyana Khomazyuk
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cognitive Impairment ◽  
High Risk ◽  
Arterial Hypertension ◽  
Social Activity ◽  
Life Quality ◽  
Cognitive Disorders ◽  
Daily Monitoring ◽  
Close Relatives

To study the relationship between quality of life (LQ) and cognitive impairment, as well as to identify risk factors for their development in patients with arterial hypertension (AH). Examined 509 outpatients with controlled AH stage II with SCORE risk of CVD <5 %. Non-dementia cognitive impairment were found 24,32±0,11 points on МCA scale in 164 (32.2 %). Patients also demonstrated a significant (p <0.001) decrease in the LQ indicators on all SF-36 scales compared to healthy ones by an average of 24.5-66.0 points. According to the results of correlation analysisthe most significant was the direct relationship between cognitive impairment on МCA scale and assessment of physical health (rs=+0,65; p<0,001), mental health (rs=+0,60; p<0,001), life activity limitations (rs=+0,33; p<0,001) and social activity (rs=+0,35; p<0,001), indicating an association between deterioration in LQ components and cognitive impairment.It turned out that the risk factors for developing cognitive impairment with AH were a history of cognitive impairment in close relatives (2.79 (95 % CI 1.15-6.77) compared with healthy people and 2.41 (95 % CI 1.01-5.88) - AH patients without cognitive impairment), a high vegetative index (rs +0.15; p <0.05) according to daily monitoring of BP and elevated levels of systolic BP variability in day and at night, that increased the chances of developing cognitive impairment in AH patients by 2.11 times, (rs = + 0.57 and rs = + 0.61; p<0.001). It was found that the likelihood of developing cognitive impairment exceeds 50 % (high risk) if the level of systolic BP variability is above 12 mm Hg in day (area under ROC curve AUC = 0.891; 95 % CI 0.883-0.940. (AUC = 0.891; 95 % CI 0.883-0.940; ST = 82.5 % and SP = 92.9 %) and at night – over 10 mm Hg (AUC = 0.922; 95 % CI 0.861-0.963; ST = 82.5 % and SP = 85.7 %) according to daily BP monitoring. In patients with AH for more than 10 years with dissatisfaction of life quality, even with controlled blood pressure, the presence of cognitive impairment needs to be clarified in immediate families, and pay attention to the high autonomic index and variability of systolic blood pressure monitored day and night, due to the high risk of development and progression of cognitive impairment, which worsens the prognosis of cardiovascular events.

When to expect cognitive disorders in hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Khomazyuk ◽  
V.U Krotova
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Arterial Hypertension ◽  
Systolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Cognitive Disorders ◽  
Monitoring Data ◽  
Moderate Degree ◽  
Daily Monitoring ◽  
Systolic Blood Pressure Variability

Abstract   In large-scale clinical studies, age, arterial hypertension (AH), multi-focal atherosclerosis, and cognitive disorders (CD) are interrelated, affecting the level of disability, quality of life, and social adaptation of patients with cardiovascular diseases. Aim of the study To determine the prognostic criteria for cognitive disorders in patients with hypertension. Methods To achieve the aim of the study, the examinations were performed in 182 outpatients with AH II stage, 34–68 years, in 164 of them were CD according to neuropsychological tests of MMSE and MoCA, mostly of mild and moderate degree. The relationship between clinical data, cognitive function characteristics and daily monitoring data of hypertension were evaluated. The data obtained were analyzed using medical methods statistics. Results Among factors such as age (&gt;60 years), gender (male / female), disease duration (&gt;10 years), waist circumference, overweight or obesity, hypercholesterolemia, no influence on the development of CD was detected (p&gt;0.05)). Risk factors for the development of CD in hypertension were an burdensome history of CD in closest relatives (2.79 (95% CI 1.15–6.77) relative to practically healthy individuals and 2.41 (1.01–5.88)), high vegetative index (rs +0,15; p&lt;0,05). The correlation between CD and high rates of blood pressure variability according to daily monitoring of blood pressure in patients with hypertension, even under conditions of blood pressure control, is confirmed by the results of correlation and one-factor logit analysis. Thus, elevated levels of systolic blood pressure variability in the day and at night increased the chances of developing CD in patients with hypertension by 2.11 times, (rs = +0.57 and rs = +0.61; p&lt;0.001). It was found that the likelihood of developing cognitive impairment exceeds 50% (high risk) if the level of systolic blood pressure variability is above 12 mm Hg in the day (area under ROC curve AUC = 0.891; 95% CI 0.883–0.940. (AUC = 0.891; 95% CI 0.883–0.940; ST = 82.5% and SP = 92.9%) and at night over 10 mm Hg (AUC = 0.922; 95% CI 0.861–0.963; ST = 82.5% and SP = 85.7%) according to daily blood pressure monitoring. Conclusion The prognosis for the development of cognitive impairment in arterial hypertension is influenced by: evidence of family CD history, autonomic nervous system index and variability of day and night blood pressure characteristics, according to ambulatory daily monitoring data. Funding Acknowledgement Type of funding source: None

scholarly journals Prevention of Arterial Hypertension in Adolescents with Existing Risk Factors in Rural Clinics

2016 ◽  
pp. 60-66
Author(s):  
Larysa Matіukha ◽  
Nataliia Orlovska ◽  
Tetiana Buchanovska
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Hypertension ◽  
Absolute Risk ◽  
Family Doctor ◽  
Exertional Dyspnea ◽  
Sinus Arrhythmia ◽  
Daily Monitoring ◽  
The Family ◽  
The Impact

The objective: to determine the frequency and impact of risk factors among adolescent children in the countryside on the possibility of arterial hypertension (AH) development and to devise the family doctor recommendations for its prevention. Patients and methods. The cohort study of 214 children at the age of 12–17 years who attend Khotiv educational complex «Secondary school of I–III levels – gymnasium» in Kiev region was implemented in order to identify the elevated numbers of blood pressure (BP) and the impact of risk factors on the development of hypertension in future. The sociological poll about the existing risk factors for cardio-vascular disease, the measurement of height and weight with the following bodymass index (BMI) calculation, the Rufe’s test for evaluating the physical efficiency, the BP measurement in the office, the electrocardiography (ECG), the blood pressure daily monitoring (BPDM) and the ophthalmoscopy were carried out. Results. Pre-hypertension was revealed among 29 children that made 13,6±2,3% of respondents, and arterial hypertension was diagnosed for 25 children that made 11,6±2,2%. Arterial hypertension was detected 2.5 times more often among boys in comparison with girls (8,3±1,9% and 3,3±1,5% accordingly). Most of respondents with arterial hypertension were 141year1old children. The most common complaints of the respondents were sleep disturbance (59,3±3,6%), exertional dyspnea (57,0±3,4%), headache (41,1±3,4%) and rapid fatigue (21,0±2,8%). The following risk factors as sex, hereditary factor for arterial hypertension especially combined with diabetes, myocardial infarction, stroke; smoking of respondents, smoking of parents, overuse of products containing the excess of table salt, insufficient use of vegetables and fruit (less than 200 g/day or no daily usage), the use of energy drinks, inactive way of life, low physical activity, the change of body weight (the overweight and the underweight) were significant. Conclusions. The frequency of arterial hypertension among the examined children who live in the countryside is 11.6%, including 8.3% among boys and 3.3% among girls. The main risk factors of arterial hypertension are the overweight, the underweight, the family history of arterial hypertension, the smoking of parents and physical inactivity of children. It has been found out that the absolute risk of arterial hypertension development in future is 40 per cent higher among the smokers, 10 per cent higher among the children whose parents smoke, 20 per cent higher among the dyspn(o)eic respondents, 20 per cent higher among the underweight children, 30 per cent higher among the overweight children, 30 per cent higher among the children with the changes of the fundus of eye, 20 per cent higher among the children with sinus tachycardia and 40 per cent higher among children with a single supraventricular extrasystole or sinus arrhythmia.

scholarly journals Risk factors for falls in patients with arterial hypertension

2019 ◽  
Vol 16 (4) ◽  
pp. 45-51
Author(s):  
Natalia O Khovasova ◽  
Anton V Naumov ◽  
Olga N Tkacheva ◽  
Victoriya I Moroz
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
High Risk ◽  
Arterial Hypertension ◽  
The Elderly ◽  
Elderly Persons ◽  
Target Values ◽  
Risk Of Falls ◽  
Common Risk Factors ◽  
Risk Factors For Falls

Falls are a serious multi-factorial problem faced by the elderly persons which is associated with serious complications, loss of functional autonomy, disability and death. One of the common comorbidities among the elderly persons is arterial hypertension (AH) which increases the risk of falls. Aim. To study the risk factors for falls among patients with AH. Materials and methods. Examined 155 patients of geriatric department with the presence of at least one fall in the last year: 133 (85.8%) women (75,29±8.31 years) and 22 (14.2%) men (79,14±4.64 years). Risk of falls and risk factors of falls were assessed in patients with AH. Results. 148 (95.5%) patients had AH. The most common risk factors for hypertension in the elderly were atherosclerosis and decreased physical activity. Target organ lesions of varying severity were observed in all patients. In 25.7% of cases, BP figures outside the target values were noted. 18 (12.2%) patients received hypotensive therapy irregularly. On avera-ge, at admission, patients received of 2.06±0.63 anti-hypertensive drug. The frequency of falls in patients with hypertension made up 2.59±2.2, two or more falls happened in 91 persons (61.5%). According to the self-assessment risk of falls scale 131 (88.5%) patients had a high risk of falls. A high risk of falling in hospital (on the Morse scale) was identified in 63 (42.6%) patients. The most common risk factors for falls in patients with AH were previous falls in anamnesis, sensory de-ficit, imbalance, osteoarthritis. The CGA results demonstrate that patients with hypertension with blood pressure below the target values in comparison with the target and even high numbers of blood pressure have a higher prevalence of frailty, worse indicators of functional status, higher incidence and high risk of falls on the Morse scale. Conclusion. The most common risk factors for falls among patients with AH are previous falls in anamnesis, sensory deficit, imbalance, osteoarthritis. For patients with hypertension, low blood pressure is a predictor of high risk of falls and a worse prognosis. When blood pressure is below the target, there is a higher prevalence of frailty and worse indicators of functional status, which is a poor prognostic sign for the elderly.

scholarly journals 338 - Risk factors for moderate cognitive impairment and dementia in the Kazakh and Kyrgyz populations (preliminary results)

2020 ◽  
Vol 32 (S1) ◽  
pp. 97-98
Author(s):  
Saule T. Turuspekova ◽  
B. Demesinova ◽  
Z. Rayimzhanov ◽  
R. Nurzhanova ◽  
L. Bespalova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Thyroid Gland ◽  
Angina Pectoris ◽  
Arterial Hypertension ◽  
Cognitive Disorders ◽  
Relative Number ◽  
Intermediate Stage ◽  
Cardiac Ischemia ◽  
Moderate Cognitive Impairment

The current demographic situation in Kazakhstan and Kyrgyzstan is associated with pronounced processes of population aging. Today, about two million elderly people live in Kazakhstan, which makes up more than 10% of the population, which crosses a seven percent threshold for determining the “aging” country in the world.For Kyrgyzstan, an increase in the proportion of the elderly is a new phenomenon. At the beginning of 2016, there were 965,385 people over 50 in Kyrgyzstan, which is 16% of the total population, of whom 60 and over are 7.06%. According to the average version of the forecast, the relative number of people 60 years and older will almost triple by 2050. (M. B. Denisenko, 2011, Report of a statistical study, 2017) The aging of the population is the most significant social problem of the XXI st century and is associated with the development of cognitive impairment and dementia. Moderate cognitive impairment, according to several authors are an intermediate stage between normal aging and dementia (Brodaty H., 2013, Peterson, 2009).The cause of cognitive disorders in old age can be a number of diseases, including neurodegenerative. According to projections, it is expected that neurodegenerative diseases will surpass cancer as the leading cause of death by 2040 (Walter U., 2013). The Global prevalence pattern of dementia depends on several factors, from life expectancy to the health status, last but not least from the particular environment.Purpose of the study. To study the prevalence of cognitive impairment and the main risk factors for their occurrence among people over 60 in the Kazakh and Kyrgyz populations.Materials and methods.The screening was attended by 300 respondents (150 Kazakhs and 150 Kyrgyz) aged 60 to 90 years (average age 65.6). The material was collected using the Questionnaire for the Champ Clinic and the MOCA test (cut-off point <26) based on the city polyclinics of Almaty and Bishkek.Results:moderate cognitive impairment was detected - 39.9%, mild cognitive impairment - 33.4%, normal cognitive function - 26.7% in Kazakhs. In the Kyrgyz population, a moderate cognitive impairment was identified - 48.3%; pronounced cognitive impairment - 15.4%, dementia - 8.2%. Expected risk factors for cognitive impairment: 1) in Kazakhs, arterial hypertension - 86.89%, cardiac ischemia, angina pectoris - 70.21%, pathology of the thyroid gland and pancreas (diabetes, hyperthyroidism and hypothyroidism) - 29.50%, atherosclerotic vascular diseases - 29.9%, brain injury - 18.22%, education level - 4.24%, depression - 0.6%, respectively. 2) in Kyrgyz: arterial hypertension - 49%, cardiac ischemia, angina pectoris - 13%, pathology of the thyroid gland and pancreas (diabetes, hyperthyroidism and hypothyroidism) - 21%, low level of education - 11%, Bad habits of smoking and alcohol - 25 %, 20%, respectively.Conclusions:The transformation of the demographic burden can have important implications for the social security system.We have an urgent need to continue screening the population to identify the main risk factors for moderate cognitive impairment in individuals in the Kazakh and Kyrgyz populations.

scholarly journals Identifying High-Risk Individuals for Chronic Kidney Disease: Results of the CHERISH Community Demonstration Project

2018 ◽  
Vol 48 (6) ◽  
pp. 447-455 ◽  
Author(s):  
Nilka Ríos Burrows ◽  
Joseph A. Vassalotti ◽  
Sharon H. Saydah ◽  
Rebecca Stewart ◽  
Monica Gannon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
High Risk ◽  
Kidney Disease ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Demonstration Project ◽  
Screening Criteria ◽  
State And Local

Background: Most people with chronic kidney disease (CKD) are not aware of their condition. Objectives: To assess screening criteria in identifying a population with or at high risk for CKD and to determine their level of control of CKD risk factors. Method: CKD Health Evaluation Risk Information Sharing (CHERISH), a demonstration project of the Centers for Disease Control and Prevention, hosted screenings at 2 community locations in each of 4 states. People with diabetes, hypertension, or aged ≥50 years were eligible to participate. In addition to CKD, screening included testing and measures of hemoglobin A1C, blood pressure, and lipids. ­Results: In this targeted population, among 894 people screened, CKD prevalence was 34%. Of participants with diabetes, 61% had A1C < 7%; of those with hypertension, 23% had blood pressure < 130/80 mm Hg; and of those with high cholesterol, 22% had low-density lipoprotein < 100 mg/dL. Conclusions: Using targeted selection criteria and simple clinical measures, CHERISH successfully identified a population with a high CKD prevalence and with poor control of CKD risk factors. CHERISH may prove helpful to state and local programs in implementing CKD detection programs in their communities.

scholarly journals ARTERIAL HYPERTENSION AND RISK FACTORS IN CHILDREN: LITERATURE REVIEW

2020 ◽  
Vol 18 (5) ◽  
pp. 523-531
Author(s):  
N. A. Maхimovich ◽  
◽  
A. V. Luksha ◽  
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
High Risk ◽  
Young People ◽  
Literature Review ◽  
Arterial Hypertension ◽  
Qualitative Analysis ◽  
Environmental Risk ◽  
Modern Society ◽  
Related Risk

Background. In modern society, there is an intensive increase in the incidence of arterial hypertension among young people, which is mainly due to lifestyle characteristics and related risk factors.Objective: to analyze the results of scientific researches of domestic and foreign authors regarding the study of risk factors in the development of arterial hypertension in children.Material and methods. A qualitative analysis of the current literature data on the risk factors for arterial hypertension and its prevention has been carried out.Results. It has been established that the occurrence of arterial hypertension in childhood is due to not only hereditary, but also a number of environmental risk factors.Conclusions. Further researches are needed to study new and established risk factors that must be considered when conducting primary prevention of the disease in children at high risk.

scholarly journals COGNITIVE IMPAIRMENT, THEIR DYNAMICS AND STRUCTURE IN THE ACUTE AND RECOVERY PERIODS OF STROKE, DEPENDING ON ARTERIAL HYPERTENSION SEVERITY AND DURATION

2018 ◽  
Vol 13 (3-4) ◽  
pp. 22-27
Author(s):  
T.M. Cherenko ◽  
Yu.L. Heletyuk
Keyword(s):  
Blood Pressure ◽  
Cognitive Impairment ◽  
Arterial Hypertension ◽  
Blood Pressure Monitoring ◽  
Cognitive Status ◽  
Neurological Deficits ◽  
Stroke Patients ◽  
Mean Values ◽  
Post Stroke ◽  
The Mean

Relevance. Cognitive impairment is common in the post-stroke period. Different characteristics of arterial hypertension (AH), namely its severity, duration and variability of blood pressure, can affect the development of cognitive impairment in stroke patients. Objective: to investigate cognitive impairment, their dynamics and structure in acute and recovering stroke periods, depending on the arterial hypertension severity and duration. Materials and methods. 150 patients with a primary ischemic stroke and history of hypertension: 74 (49,3 %) women and 76 (50,7 %) men, the mean age (67,4±0,7) years have been examined. Neurological deficits was evaluated by the NIHSS scale. The cognitive status was evaluated by the MMSE scale at the end of an acute period of 21 days and 1 year. Diagnosis of hypertension was based on the clinical and instrumental examination results and medical documents. Daily blood pressure monitoring was using on admission and every 4 hours during 6 days of acute stroke stage. Mean SBP, mean DBP, maximum SBP and DBP, standard deviation (SD) of SBP and DBP were studied. Results. By the mean score on the MMSE scale, there are differences in patients during acute post-stroke period, depending on the severity of hypertension: 27,2±0,6 points in the case of hypertension stage 1, 24,3±0,6 in the case of hypertension stage 2 and 20,7±0,8 in case of AH stage 3, (p=0.001). By this indicator, patients with different AH duration were different: 26,4±0,9 points; 25,1±0,5 points; 20,5±0,7 points, respectively. The significance of these differences by the mean values of MMSE score was obtained in patients with a duration of AH less than 5 years and more than 10 years, as well as when comparing the group of "6-10 years" and "over 10 years" (p=0,001). Significant differences in the structure of cognitive deficits severity, depending on the hypertension stage and its duration, were observed only in patients with moderate and severe stroke (p=0,006). Cognitive deterioration a year after a stroke was observed in 40 (31,5 %) patients. They have significantly higher mean values SD 1-3, SD 1-6, SBP on the first day after a stroke, and duration of hypertension. Conclusions. The relationship between the degree of intellectual decline and the duration of hypertension (r=0,592, p=0,001), severity of hypertension (r=0,459, p=0,001) was found. The severity of the neurological deficiency affects the structure of cognitive impairment at discharge in patients with different severity and duration of hypertension, and higher mean values of the variability of blood pressure from 1 to 6 days, SBP on the first day after stroke and higher duration of hypertension in the history is associated with a negative dynamics of cognitive impairment in stroke patients in a year after stroke.

scholarly journals Chronic heart failure as multimorbid state

2019 ◽  
Vol 26 (4) ◽  
pp. 90-101 ◽  
Author(s):  
L. G. Voronkov ◽  
A.V. Liashenko ◽  
N. A. Tkach ◽  
L. P. Paraschenyuk
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Cognitive Impairment ◽  
Chronic Heart Failure ◽  
Iron Deficiency ◽  
Arterial Hypertension ◽  
Renal Dysfunction ◽  
Life Quality ◽  
High Class ◽  
High Level

Regulatory, structural and functional disturbances of other organs and systems (kidney, hepar, vessels, skeletal muscles, brain etc) play the substantial role in CHF. These disturbances may be the conseguences of pre-existing states (hypertension, diabetes, hypo- or hyperthyreoidism etc) and from, other side, may reflect the progressive inherent changes in chronic heart failure (CHF) per se. In particular, currently relevant comorbidities in this syndrome are insulin resistance, diabetes mellitus, renal dysfunction, cognitive impairment, depression peripheral myopathy. Every of them demonstrate the close pathophysiologic interplay with CHF which results in clinical prognosis impairment and in decrease of life quality. Prevalence of renal dysfunction described in 39 % of patients with CHF in our research. Renal dysfunction connected with older age, high class of NYHA, diabetes mellitus, arterial hypertension, higher level of citrulline and uric acid in patients with CHF. Patients with iron deficiency characterized with high class of NYHA, low functionality and poor quality of life. In patients with iron deficiency noted high level of mortality and many critical clinical events. Prevalence of cognitive impairment described in 85 % of patients with CHF in our research. Cognitive dysfunction associated with older age, high class of NYHA, diabetes mellitus, arterial hypertension, bad life quality, high level of ceruloplasmin in patients with CHF. Taking to account above-mentioned comorbidities in quideline-recommended management of CHF and the use of additional therapeutic approaches targeted to its treatment represent the contemporary strategy of personalized treatment in this syndrome.

scholarly journals Development of a Sex-Specific Risk Scoring System for Predicting Cognitive Normal to Mild Cognitive Impairment (SRSS-CNMCI)

2021 ◽  
Author(s):  
Wen Luo ◽  
Hao Wen ◽  
Shuqi Ge ◽  
Chunzhi Tang ◽  
Xiufeng Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
High Risk ◽  
Scoring System ◽  
External Validation ◽  
Scoring Systems ◽  
Cutoff Point ◽  
Risk Scoring ◽  
Risk Scoring System

Abstract Objective: We aim to develop a sex-specific risk scoring system for predicting cognitive normal (CN) to mild cognitive impairment (MCI), abbreviated SRSS-CNMCI, to provide a reliable tool for the prevention of MCI.Methods: Participants aged 61-90 years old with a baseline diagnosis of CN and an endpoint diagnosis of MCI were screened from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database with at least one follow-up. Multivariable Cox proportional hazards models were used to identify risk factors associated with conversion from CN to MCI and to build risk scoring systems for male and female groups. Receiver operating characteristic (ROC) curve analysis was applied to determine the risk probability cutoff point corresponding to the optimal prediction effect. We ran an external validation of the discrimination and calibration based on the Harvard Aging Brain Study (HABS) database.Results: A total of 471 participants, including 240 women (51%) and 231 men (49%), aged 61 to 90 years, were included in the study cohort for subsequent primary analysis. The final multivariable models and the risk scoring systems for females and males included age, APOE ε4, Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). The scoring systems for females and males revealed C statistics of 0.902 (95% CI 0.840-0.963) and 0.911 (95% CI 0.863-0.959), respectively, as measures of discrimination. The cutoff point of high and low risk was 33% in females, and more than 33% was considered high risk, while more than 9% was considered high risk for males. The external validation effect of the scoring systems was good: C statistic 0.950 for the females and C statistic 0.965 for the males. Conclusions: Our parsimonious model accurately predicts conversion from CN to MCI with four risk factors and can be used as a predictive tool for the prevention of MCI.

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