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Vascular risk factors and cognitive function among 3763 participants in the Hypertension in the Very Elderly Trial (HYVET): a cross-sectional analysis

  • Ruth Peters (a1), Nigel Beckett (a2), Françoise Forette (a3), Jaakko Tuomilehto (a4), Craig Ritchie (a2), Ivan Walton (a5), Adam Waldman (a5), Robert Clarke (a6), Ruth Poulter (a1), Astrid Fletcher (a7) and Christopher Bulpitt (a1)...

Abstract

Background: It is well known that the global population is aging and that those over the age of 80 are the fastest growing part of this expansion. Also known is that prevalence of hypertension and cognitive decline both increase with increasing age.

Method: The Hypertension in the Very Elderly Trial (HYVET) was a double blind placebo-controlled trial of antihypertensive treatment (indapamide SR 1.5 mg ± perindopril 2–4 mg) and recruited only those hypertensives who were aged 80 or over and were without a diagnosis of dementia at baseline. Systolic blood pressure had to be in the range 160–199 mmHg and diastolic pressure <110 mmHg. Cognitive function was assessed at baseline using the Mini-mental State Examination prior to randomization into the trial. Also collected at baseline was information relating to sociodemographic, clinical, cardiovascular and biochemical factors which may impact upon cognitive function. This paper reports on the baseline cognitive function data from the HYVET trial and its relationship to these factors.

Results: The mean age of the 3763 HYVET participants who had full cognitive function data at baseline was 83.6 years; 60 percent were female. The median MMSE score at baseline was 26 and, in multivariate analyses, higher at younger age, with male gender, higher educational level, having higher creatinine, higher total cholesterol and lower high-density lipoprotein cholesterol.

Conclusions: This is the first such study to examine a large number of very elderly hypertensives and it shows some similar patterns to those seen in younger elderly groups.

Copyright

Corresponding author

Correspondence should be addressed to: Dr. Ruth Peters, Care of the Elderly, Imperial College Faculty of Medicine, Du Cane Rd, London W12 0NN, U.K. Tel. +44 (0)20 83833959; Fax. +44 (0)20 83833378. Email: r.peters@imperial.ac.uk.

References

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Anstey, K., Sanden, C., Salim, A. and O'Kearney, R. (2007). Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. American Journal of Epidemiology, 166, 367378.
Arai, H. et al. (2006). Usefulness of measuring serum markers in addition to comprehensive geriatric assessmet for cognitive impairment and depressive mood in the elderly. Geriatric Gerontology International, 6, 714.
Baum, L. (2005). Sex, hormones and Alzheimer's disease. Journal of Gerontology, 60A, 736743.
Beckett, N. et al. for the HYVET Study Group (2008). Treatment of hypertension in patients 80 years of age or older, New England Journal of Medicine, 358, 18871898.
Birkenhager, W., Forette, F., Seux, M., Wang, J. and Staessen, J. (2001). Blood pressure, cognitive functions, and prevention of dementias in older patients with hypertension. Archives of Internal Medicine, 161, 152156.
Bulpitt, C. et al. (2001). Hypertension in the Very Elderly Trial (HYVET) protocol for the main trial. Drugs and Aging, 18, 151164.
Cankurtaran, M., Yavuz, B., Halil, M., Dagli, N., Cankurtaran, E. and Ariogul, S. (2005). Are serum lipid and lipoprotein levels related to dementia? Archives of Gerontology and Geriatrics, 41, 3139.
Donini, L., Felice, M. and Cannella, C. (2007). Nutritional status determinants and cognition in the elderly. Archives of Gerontology and Geriatrics, 44, 143153.
Elias, M., Wolf, P., D'Agostino, R., Cobb, J. and White, L. (1993). Untreated blood pressure level is inversely related to cognitive functioning: the Framingham study. American Journal of Epidemiology, 138, 353364.
Feigin, V., Ratnasabapathy, Y. and Anderson, C. (2005). Does blood pressure lowering treatment prevents dementia or cognitive decline in patients with cardiovascular and cerebrovascular disease? Journal of the Neurological Sciences, 229–230, 151–155.
Fratiglioni, L. et al. for the Neurologic Diseases in the Elderly Research Group (2005). Incidence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurology, 54, S10S15.
Geroldi, C. et al. (2003). Mild cognitive deterioration with subcortical features. prevalence, clinical characteristics, and association with cardiovascular risk factors in community-dwelling older persons (the InCHIANTI Study). Journal of the American Geriatrics Society, 51, 10641071.
Hersberger, M. and Eckardstein, A. (2003). Low high-density lipoprotein cholesterol: physiological background, clinical importance and drug treatment. Drugs, 63, 19071945.
Kalmijn, S., Feskens, E., Launer, L. and Kromhout, D. (1996).Cerebrovascular disease, the apolipoprotein e4 allele, and cognitive decline in a community based study of elderly men. Stroke, 27, 22302235.
Kilander, L., Nyman, H., Boberg, M., Hansson, L. and Lithell, H. (1998). Hypertension is related to cognitive impairment: a 20-year follow-up of 999 men. Hypertension, 31, 780786.
Kivipelto, M. et al. (2001). Midlife vascular risk factors and late-life mild cognitive impairment: a population-based study. Neurology, 561, 16891689.
Launer, L., Masaki, K., Petrovitch, H., Foley, D. and Havlik, R. (1995). The association between midlife blood pressure levels and late-life cognitive function. JAMA, 274, 18461851.
Norbury, R. et al. (2003). The neuroprotective effects of oestrogen on the aging brain. Experimental Gerontology, 38, 109117.
Packard, C. et al. for the Prospective Study of Pravastatin in the Elderly at Risk Group. (2007). Association between apolipoprotein e4 and cognitive decline in elderly adults. Journal of the American Geriatrics Society, 55; 17771785.
Peters, R., Beckett, N., Nunes, M., Fletcher, A., Forette, F. and Bulpitt, C. (2006). A substudy protocol of the Hypertension in the Very Elderly Trial assessing cognitive decline and dementia incidence (an ongoing randomised double blind placebo-controlled trial). Drugs and Aging, 23, 8392.
Peters, R. et al. for the HYVET investigators (2008a). Incident dementia and blood pressure lowering in the Hypertension in the Very Elderly Trial cognitive function assessment (HYVET-COG): a double-blind, placebo controlled trial. Lancet Neurology, 7, 683689, doi. 10.1016/S1474-4422(08)70143-1.
Peters, R., Peters, J., Warner, J., Beckett, N. and Bulpitt, C. (2008b).Alcohol, dementia and cognitive decline in the elderly: a systematic review. Age and Ageing, 37, 505512.
Prospective Studies Collaboration (2007). Blood pressure and vascular mortality by age, sex and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet, 370, 18291839.
Qiu, C., Strauss, E., Fastbom, J., Winblad, B. and Fratiglioni, L. (2003). Low blood pressure and risk of dementia in the Kungsholmen project. Archives of Neurology, 60, 223228.
Qiu, C., Winblad, B. and Fratiglioni, L. (2005). The age-dependent relation of blood pressure to cognitive function and dementia. Lancet Neurology, 4, 487499.
Ruitenberg, A. et al. (2002). Alcohol consumption and risk of dementia: the Rotterdam study. Lancet, 359, 281286.
Solomon, A. et al. (2007). Serum cholesterol changes after midlife and late-life cognition: twenty-one-year follow-up study. Neurology, 68, 751756.
Spreen, O. and Strauss, E. (1998). A Compendium of Neuropsychological Tests. Administration, Norms and Commentary, 2nd edn. Oxford: Oxford University Press.
Steen, B. (2002). The elderly yesterday, today and tomorrow: aspects on cohort differences from the gerontological and geriatric population studies in Göteburg, Sweden (H70). Archives of Gerontology and Geriatrics, 35, 359370.
Stewart, R., White, L., Xue, Q. and Launer, L. (2007). Twenty-six-year change in total cholesterol levels and incident dementia. Archives of Neurology, 64, 103107.
Tzourio, C., Dufouil, C., Ducimetière, P., and Alpérovitch, A. for the EVA Study Group (1999). Cognitive decline in individuals with high blood pressure: a longitudinal study in the elderly. Neurology, 53, 19481952.
Vanhanen, H. et al. on behalf of the Syst-Eur Investigators (1996). Associations of orthostatic blood pressure fall in older patients with isolated systolic hypertension. Journal of Hypertension, 14, 943949.
Yaffe, C., Barratt-Connor, E., Lin, F. and Grady, D. (2002). Serum lipoprotein levels, statin use, and cognitive function in older women. Archives of Neurology, 59, 378384.

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