Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: The cardiovascular health study

Ihab Hajjar, Lien Quach, Frances Yang, Paulo H M Chaves, Anne B. Newman, Kenneth Mukamal, Will Longstreth, Marco Inzitari, Lewis A. Lipsitz

Research output: Contribution to journalArticle

Abstract

Background- Our objective was to investigate the association between hypertension and concurrent impairments in mobility, cognition, and mood; the role of brain white matter hyperintensities in mediating this association; and the impact of these impairments on disability and mortality in elderly hypertensive individuals. Methods and Results- -Blood pressure, gait speed, digit symbol substitution test, and the Center for Epidemiological Studies Depression Scale were measured yearly (1992-1999) on 4700 participants in the Cardiovascular Health Study (age: 74.7, 58% women, 17% blacks, 68% hypertension, 3600 had brain magnetic resonance imaging in 1992-1993, survival data 1992-2005). Using latent profile analysis at baseline, we found that 498 (11%) subjects had concurrent impairments and 3086 (66%) were intact on all 3 measures. Between 1992 and 1999, 651 (21%) became impaired in all 3 domains. Hypertensive individuals were more likely to be impaired at baseline (odds ratio 1.23, 95% confidence interval 1.04 to 1.42, P=0.01) and become impaired during the follow-up (hazard ratio=1.3, 95% confidence interval 1.02 to 1.66, P=0.037). A greater degree of white matter hyperintensities was associated with impairments in the 3 domains (P=0.007) and mediated the association with hypertension (P=0.19 for hypertension after adjusting for white matter hyperintensities in the model, 21% hazard ratio change). Impairments in the 3 domains increased subsequent disability with hypertension (P

Original languageEnglish (US)
Pages (from-to)858-865
Number of pages8
JournalCirculation
Volume123
Issue number8
DOIs
StatePublished - Mar 1 2011

Fingerprint

Cognition
Hypertension
Health
Confidence Intervals
Brain
Proportional Hazards Models
Epidemiologic Studies
Odds Ratio
Magnetic Resonance Imaging
White Matter
Depression
Blood Pressure
Survival
Mortality

Keywords

  • disability
  • hypertension
  • white matter hyperintensities

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood : The cardiovascular health study. / Hajjar, Ihab; Quach, Lien; Yang, Frances; Chaves, Paulo H M; Newman, Anne B.; Mukamal, Kenneth; Longstreth, Will; Inzitari, Marco; Lipsitz, Lewis A.

In: Circulation, Vol. 123, No. 8, 01.03.2011, p. 858-865.

Research output: Contribution to journalArticle

Hajjar, I, Quach, L, Yang, F, Chaves, PHM, Newman, AB, Mukamal, K, Longstreth, W, Inzitari, M & Lipsitz, LA 2011, 'Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood: The cardiovascular health study', Circulation, vol. 123, no. 8, pp. 858-865. https://doi.org/10.1161/CIRCULATIONAHA.110.978114
Hajjar, Ihab ; Quach, Lien ; Yang, Frances ; Chaves, Paulo H M ; Newman, Anne B. ; Mukamal, Kenneth ; Longstreth, Will ; Inzitari, Marco ; Lipsitz, Lewis A. / Hypertension, white matter hyperintensities, and concurrent impairments in mobility, cognition, and mood : The cardiovascular health study. In: Circulation. 2011 ; Vol. 123, No. 8. pp. 858-865.
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