Study On Relationship Between Primary Aldosteronism And Cognitive Impairment

Objective: To explore the relationship between primary aldosteronism(PA)and cognitive dysfunction,and to find the risk factors affecting cognitive function in PA patients.Methods: Patients with hypertension who were admitted to the Department of Cardiology of the Second Affiliated Hospital of Nanchang University from June 2020 to December 2020 were selected,99 patients were diagnosed with essential hypertension(EH)and 52 with PA,they were divided into PA group and EH group.The Montreal Cognitive Assessment Scale(Mo CA)was used for Cognitive function Assessment,and the Center for Epidemiologic Studies Depression Scale(CESD)was used for Depression symptoms Assessment.The general data of the patients were collected,and the clinical biochemical indexes and dynamic blood pressure results were analyzed.Spearman correlation analysis was used to analyze the correlation between the indexes of PA patients and Mo CA score,and multiple linear regression analysis was used to explore the independent risk factors of cognitive impairment in PA patients.Results:(1)The level of aldosterone in PA group was significantly higher than that in EH group(P < 0.001),ARR in PA group was significantly higher than that in EH group(P < 0.001),Aldosterone level in PA group was significantly higher than that in EH group(P < 0.001),ARR in PA group was significantly higher than that in EH group(P < 0.001),and serum potassium level in PA group was significantly lower than that in EH group(P < 0.001).In terms of blood pressure,the systolic blood pressure of PA group was significantly higher than that of EH group(P =0.02),while the average diastolic blood pressure of PA group was not significantly different from that of EH group(P > 0.05).(2)Mo CA score of PA group was lower than that of EH group,but there was no significant difference(P > 0.05).The cognitive impairment rate in PA group was significantly higher than that in EH group(P < 0.05).There was no significant difference in CESD scores between the two groups(P < 0.05).(3)Older age(B=-0.149,95%CI:-0.245,-0.054,P =0.003),women(B=-2.434,95%CI:-4.041,-0.827,P =0.004),higher average daylong diastolic blood pressure(B=-0.092,95%CI:-0.177,-0.006,P =0.036)and lower educational level(B=1.631,95%CI: 0.608,2.653,P =0.003)were independent factors of impaired cognitive function in PA patients.Conclusion:(1)Cognitive impairment was significantly higher in PA patients than in EH patients,while there was no significant difference in depressive symptoms between PA patients and EH patients.(2)Older age,women,higher mean diastolic blood pressure and lower education level are independent risk factors for cognitive dysfunction in PA patients.