Hipertensão arterial e déficit cognitivo

• Ano de defesa: 2012
• Autor(a) principal: Dias, Eros da Mota
• Orientador(a): Toledo, Juan Carlos Yugar
• Banca de defesa: Tácito, Lúcia Helena Bonalume , Moreno Junior, Heitor , Freitas, Olavo de Carvalho
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Faculdade de Medicina de São José do Rio Preto
• Programa de Pós-Graduação: Programa de Pós-Graduação em Ciências da Saúde::123123::600
• Departamento: Medicina Interna; Medicina e Ciências Correlatas::123123::600
• País: BR
• Palavras-chave em Português: hipertensão arterial; déficit cognitivo; espessura íntima média carótidas; pressão sistólica central; hipertensão
• Palavras-chave em Inglês: hypertension; cognitive impairment; intima-media thickness; carotid; central systolic pressure
• Palavras-chave em Espanhol: Hipertensión
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::CARDIOLOGIA::123123::600
• Link de acesso: http://bdtd.famerp.br/handle/tede/155

The role of hypertension in the loss of cognitive function is controversial. Relationships of hypertension with increases in cerebral vascular resistance, diffused lesions and multiple lacunars infarct of the white matter are well known. Objectives- To evaluate the relationship between hypertension and cognitive deficiency (CD), identify risk factors associated with the development of CD and determine the association between markers of early vascular disease and CD in hypertensive individuals. Methods- One hundred and ninety eight individuals aged between 40 and 80 years old were evaluated. Forty eight participants were normotensive (NT). The remaining 150 hypertensive patients were subdivided into two groups, those with CD (HCD) and those without CD (HNCD). All participants underwent clinical evaluations and complete physical examinations and biochemical blood tests were performed. CD was investigated using the Mini Mental State Examination (MMSE) following the guidelines for its use in Brazil. The impact of hypertension on the arterial bed was assessed by identifying and measuring changes in the intima-media thickness (IMT) by vascular ultrasonography of the carotid arteries and analyses of the central blood pressure and Augmentation Index by applanation tonometry of the radial artery. Results- There were no significant differences in the plasma concentrations of total cholesterol, high density lipoprotein cholesterol and triglycerides of the three groups. The serum creatinine and estimated glomerular filtration rate where within normal ranges for all three groups. However, significantly higher values were found for the HCD and HNCD Groups compared to the NT Group (p-value < 0.05). A significantly lower MMSE score was recorded for the HCD Group compared to the HA and NT Groups (p-value < 0.05). The IMT was significantly different between the HNCD and HCD Groups (p-value = 0.0124). A significant difference in the IMT was also observed between hypertensive patients and the NT Group (p-value < 0.0001). The central systolic pressure was significantly higher in the HCD and HNCD Groups compared to NT Group (p-value < 0.0001). There were no significant differences in the Augmentation Index (corrected for heart rate) between the three groups (HNCD, HCD and NT). Conclusions- Hypertensive patients with CD have changes in the vascular morphology characterized by an increased carotid IMT and hemodynamic functional impairment manifested by elevated central systolic blood pressure.