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J Am Heart Assoc. 2017 Oct 10;6(10). pii: e005561. doi: 10.1161/JAHA.117.005561.

Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial.

Zhang J1,2,3, Tang G4, Xie H5, Wang B4,6, He M7, Fu J1,2,3, Shi X1,2,3, Zhang C5, Huo Y8, Xu X4,6, Wang K9,2,3.

Author information

1
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
2
Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, China.
3
Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
4
Institute for Biomedicine, Anhui Medical University, Hefei, China.
5
Department of Neurology, The Affiliated Foshan Hospital of Sun Yat-sen University, Foshan, China.
6
National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, China.
7
Department of Neurology, The First People's Hospital of Lianyungang, Lianyungang, China.
8
Department of Cardiology, Peking University First Hospital, Beijing, China.
9
Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China wangkai1964@126.com.

Abstract

BACKGROUND:

Obesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is correlated with longitudinal cognitive performance in hypertensive adults.

METHODS AND RESULTS:

The analysis included 16 791 patients in the CSPPT who received at least 2 cognitive assessments by the Mini-Mental State Examination (MMSE) during the follow-up (median, 4.5 years; interquartile range, 4.2-4.8 years). Outcomes included changes in MMSE scores and cognitive impairment (defined as MMSE score less than education-specific cutoff point). A marked reduction in MMSE scores at the final (compared with at the 1-year) follow-up was apparent in both men (n=4838; mean [SD] score, 0.41 [3.62]) and women (n=7190; mean [SD] score, 1.07 [4.61]; both P<0.001). Analysis using a mixed-effects model revealed an association between higher body mass index with less MMSE decline, even after controlling for demographics and comorbidities (men, β=0.0134 [SE, 0.0036]; women, β=0.0133 [SE, 0.0034]; both P<0.001). A total of 1037 men (15.3%) and 3317 women (33.1%) developed cognitive impairment. In multivariable Cox regression analyses, being obese in men (11.3% versus 18.0%; hazard ratio, 0.75; 95% confidence interval, 0.60-0.94) and women (30.1% versus 36.5%; hazard ratio, 0.82; 95% confidence interval, 0.74-0.91) was a protective factor against cognitive impairment compared with normal body mass index.

CONCLUSIONS:

Higher adiposity is independently associated with slower cognitive decline in Chinese hypertensive adults.

CLINICAL TRIAL REGISTRATION:

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885 CSPPT.

KEYWORDS:

adiposity; body mass index; cognitive decline; hypertension; waist circumference

PMID:
29018022
PMCID:
PMC5721823
DOI:
10.1161/JAHA.117.005561
[Indexed for MEDLINE]
Free PMC Article

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