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Am J Hypertens. 2016 Apr;29(4):464-9. doi: 10.1093/ajh/hpv122. Epub 2015 Aug 12.

Endothelial Activation Is Associated With Cognitive Performance in Patients With Hypertension.

Author information

1
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands; renske.uiterwijk@mumc.nl.
2
Department of Psychiatry and Psychology, Maastricht University Medical Centre, Maastricht, The Netherlands;
3
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands;
4
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands;
5
Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
6
Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands; Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands;

Abstract

BACKGROUND:

Hypertension is associated with the occurrence of cognitive deficits and dementia, probably because hypertension is a major risk factor for the occurrence of brain damage as a result of cerebral small vessel disease (cSVD). Endothelial activation and inflammation have been suggested to play an important role in the pathogenesis of cSVD. We investigated if compound scores of endothelial activation or inflammation, based on several blood markers, are associated with cognitive performance 3 years later in patients with essential hypertension.

METHODS:

At baseline, levels of blood markers of endothelial activation (soluble vascular cellular adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), sP-selectin, and sE-selectin) and markers of inflammation (neopterin, C-reactive protein, and sICAM-1) were measured and transformed into compound scores using z-scores. In addition, a brain magnetic resonance imaging (MRI) was performed to determine the presence of cSVD-related MRI markers. Three years later, patients underwent a neuropsychological assessment to determine cognitive performance.

RESULTS:

A total of 101 patients with hypertension were included in the present study. In multiple linear regression analyses with correction for demographics and MRI markers, the compound score of endothelial activation (B = -0.19, 95% confidence interval = -0.34 to -0.04, P = 0.014), but not of inflammation (B = -0.09, 95% confidence interval = -0.22 to 0.05, P = 0.198), was associated with worse cognitive performance.

CONCLUSIONS:

Our results show that an overall measure of endothelial activation is associated with cognitive performance in patients with essential hypertension. This indicates that a process involving endothelial activation might play a role in the pathogenesis of cognitive problems in patients with hypertension.

KEYWORDS:

blood pressure; cerebral small vessel disease; cognition; endothelial activation; hypertension; inflammation.

PMID:
26271106
PMCID:
PMC4886483
DOI:
10.1093/ajh/hpv122
[Indexed for MEDLINE]
Free PMC Article

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