Effects of intensive blood pressure control on cognitive function in patients with cerebral small vessel disease |
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| Affiliation: | 1. Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea;2. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;3. Division of Cardiology, Department of Internal Medicine, Sejong Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea;4. Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;5. Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;6. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;1. Faculty of Medicine, University of Southampton, Tremona Road, SO16 6YD, UK;2. Centre for Clinical Brain Sciences, University of Edinburgh, UK;3. Institute of Neuroscience, Campus for Ageing and Vitality, Newcastle University, UK;1. Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA;2. Parkland Memorial Hospital, Dallas, TX, USA;1. Alumnus of College of Nursing and Health Innovation, University of Texas at Arlington. 411 S. Nedderman, Box 19407, Arlington, TX 76019, USA;2. College of Nursing and Health Innovation, University of Texas at Arlington. 411 S. Nedderman, Box 19407, Arlington, TX 76019, USA;3. 909 N Washington Ave, Dallas, TX 75246, USA |
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| Abstract: | ObjectiveThis study aimed to investigate the effects of intensive blood pressure control on cognitive function in elderly patients with cerebral small vessel disease (CSVD).MethodsFrom May 2020 to June 2022, 140 outpatients and inpatients with CSVD and hypertension in the Department of Neurology of Beijing Shijingshan Hospital were selected. They were randomly divided into the standard and intensive blood pressure control groups, and the dosage of antihypertensive drugs was adjusted to reduce the blood pressure to the target level. The patients were followed up for 2 years. The medical records or data at “enrollment” and “2-year follow-up” were analyzed and evaluated. The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate cognitive function. Cranial magnetic resonance imaging was performed to evaluate lacunar infarctions (LIs) and white matter hyperintensity (WMH). Multiple linear regression was used to analyze the correlation between MMSE scores and blood pressure, WMH, and LIs.Results(1) The MMSE and MoCA scores in the standard group were significantly lower than those at enrollment. The WMH score in the standard group was significantly higher than that at enrollment. (2) After the 2-year follow-up, the 24-h systolic blood pressure (SBP), 24-h diastolic blood pressure (DBP), daytime mean SBP, daytime mean DBP, and nighttime mean SBP in the two groups significantly decreased, which had significant statistical significance (P < 0.05). (3) The correlation between blood pressure and MMSE score was analyzed using multiple linear regression analysis. The WMH score, LIs, 24-h SBP, and 24-h DBP were independently correlated with MMSE scores.ConclusionIn elderly patients with hypertension, a decrease in SBP to 126 mmHg, compared with 134 mmHg, can delay cognitive impairment as well as reduce LIs and cerebral WMH lesions in patients with CSVD. |
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