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Hypertension, Vol 22, 771-779, Copyright © 1993 by American Heart Association
J Kuusisto, K Koivisto, L Mykkanen, EL Helkala, M Vanhanen, T Hanninen, K Pyorala, P Riekkinen and M Laakso
The relation between hypertension and cognitive function is not well
established. Therefore, we examined cognitive function in a random sample
of 744 nondiabetic elderly inhabitants of Kuopio, East Finland. Five brief
neuropsychological tests known to be sensitive to cognitive impairment due
to dementia--the Mini-Mental State Examination (MMSE), the Trail Making
Test (TMT), the Buschke Selective Reminding Test (BSR), Russell's
Adaptation of the Visual Reproduction Test (HVR), and the Verbal Fluency
Test (VFT)--were used to evaluate cognitive function. The performance of
the hypertensive group (n = 378) was impaired in almost all test items
compared with that of the normotensive group (n = 366), but the difference
between these two groups was statistically significant in 5 of 19 test
items only. Moreover, within the hypertensive group, hyperinsulinemic
(fasting plasma insulin > 17.9 mU/L) hypertensive subjects (n = 57)
scored worse than normoinsulinemic hypertensive subjects (n = 321) in 16 of
19 test items and worse than the normotensive subjects in the same 16 of 19
test items. The difference between the hyperinsulinemic hypertensive and
normotensive groups was significant in 11 test items that reflected complex
cognitive function such as calculation, language, semantic memory, and
problem solving. This difference in neuropsychological tests among the
three study groups (normotensive, normoinsulinemic hypertensive, and
hyperinsulinemic hypertensive subjects) persisted after adjustment for
fasting plasma glucose, age, sex, and education in 3 test items measuring
calculation, copying, and semantic memory. Thus, essential hypertension in
the elderly is associated with an impairment in complex cognitive
function.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Essential hypertension and cognitive function. The role of hyperinsulinemia
Department of Medicine, Kuopio University Hospital, Finland.
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