Cognitive function and blood pressure control in hypertensive patients over 60 years of age: COGNIPRES study

Abstract

Background and aims: The aim of the COGNIPRES study was to analyze the prevalence of cognitive impairment in hypertensive individuals over 60 years of age, treated in primary care centres in the context of routine clinical practice. Degree of blood pressure control and treatment compliance, as well as other possible factors that influence cognitive function, were also evaluated.

Methods: An epidemiological, multicentre cross-sectional study was made. Demographic, clinical, therapeutic and blood pressure data for the first three hypertensive patients aged over 60 years seen in the primary care centre, and for the first patient visited at home by the physician were recorded. The study was carried out by 477 physicians in 333 primary care centres throughout Spain. Cognitive impairment was assessed using the Mini Mental State Examination (MMSE), and therapeutic compliance was assessed using the Haynes-Sacket and Morisky-Green tests.

Results: Of 1579 patients included in the study, 12.3% (95%CI 10.7-14.0) (n=195) had cognitive impairment. This was significantly associated with patients over 80 years of age (OR 4.97; 95%CI 2.98-8.29), exclusive home care (OR 1.84; 95%CI 1.19-2.83), anxiety (OR 1.84; 95%CI 1.19-2.83), stroke or transient ischemic attack (OR 4.37; 95%CI 2.81-6.78), Parkinson's disease (OR 8.15; 95%CI 2.54-26.12), essential tremor (OR 2.25; 95%CI 1.34-3.79), uncontrolled blood pressure (OR 0.60; 95%CI 0.39-0.94) and poor treatment compliance (OR 0.53; 95%CI 0.37-0.75). Overall, 28.3% of the patients showed controlled blood pressure, and 33.6% showed poor adherence to antihypertensive treatment.

Conclusions: In this study, the prevalence of cognitive impairment in hypertensive patients aged over 60 years was 12.3%. Less than a third of the patients had good blood pressure control. Compliance with therapy and good control of blood pressure are associated with better MMSE scores.