Journal
AMERICAN JOURNAL OF HYPERTENSION
Volume 30, Issue 6, Pages 624-631Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ajh/hpx023
Keywords
antihypertensive treatment; blood pressure; blood pressure control; cognition; hypertension; HCHS/SOL; Hispanics/Latinos
Categories
Funding
- National Heart, Lung, and Blood Institute (NHLBI) [N01-HC65233]
- University of Miami [N01-HC65234]
- Albert Einstein College of Medicine [N01-HC65235]
- Northwestern University [N01-HC65236]
- San Diego State University [N01-HC65237]
- National Center on Minority Health and Health Disparities
- National Institute of Deafness and Other Communications Disorders
- National Institute of Dental and Craniofacial Research
- National Institute of Diabetes and Digestive and Kidney Diseases
- National Institute of Neurological Disorders and Stroke
- Office of Dietary Supplements
- NIA [K01-AG040192]
- [AG48642]
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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.
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