The independent association of hypertension with cognitive function among older adults with heart failure

Objective: Hypertension is the most common comorbidity among heart failure (HF) patients and has been independently linked with cognitive impairment. Cognitive impairment is prevalent among HF patients, though the extent to which hypertension contributes to cognitive function in this population is unclear. Methods: 116 HF patients (31.0% women, 67.68 +/- 11.16 years) completed neuropsychological testing and impedance cardiography. History of physician diagnosed hypertension, along with other medical characteristics, was ascertained through a review of participants' medical charts. Results: 69.8% of the HF patients had a diagnostic history of hypertension. After adjustment for demographic and medical characteristics (i.e., cardiac index, medication status, and resting blood pressure), hypertension was independently associated with attention/executive function/psychomotor speed (Delta F( 1.103) = 10.85, Delta R-2 = .07, p <.01) and motor functioning (Delta F(1,103)= 4.46, Delta R-2 = .04, p <.05). HF patients with a diagnosed history of hypertension performed worse in these domains than those without such history. Conclusion: The current findings indicate that diagnostic history of hypertension is an important contributor to cognitive impairment in HF. Hypertension frequently precedes HF and future studies should examine whether sustained hypertension compromises cerebral autoregulatory mechanisms to produce brain damage and exacerbate cognitive impairment in this population. (C) 2012 Elsevier B.V. All rights reserved.