Study On The Clinical Characteristics And Related Factors Of Cognitive Dysfunction In Elderly Patients With Hypertension

Objective:1.To explore the clinical features and risk factors of cognitive dysfunction in elderly patients with hypertension.2.To explore the changes of related indexes and clinical diagnostic value of cognitive dysfunction in elderly patients with hypertension,so as to provide clinical basis for the early recognition of cognitive dysfunction in elderly patients with hypertension.Methods:A total of 184 patients with essential hypertension who were admitted to Shanxi Bethune Hospital from August 2019 to August 2020 were randomly selected,with age≥60 years old and course of hypertension ranging from 1 to 20 years.Montreal Cognitive Assessment Scale(MOCA)was used to evaluate their cognitive function,and they were divided into VCI group(n=90)and control group(n=94),Collection may affect cognitive impairment of patients with essential hypertension(EH)with various relevant factors,including basic demographic characteristics and lifestyle,hypertension,clinical characteristics and general biochemical indexes.Detection of Angiotensin Ⅱ,Aldosterome,Endothelin-1,Adiponectin and urinary angiotensinogen levels.The levels of serum angiotensin Ⅱ,endothelin-1,adiponectin and urinary angiotensinogen were determined.Pearson correlation analysis was used to analyze the correlations.Logistic regression analysis was used to determine the independent factors.And receiver operating characteristic curve(ROC)was used to assess the diagnosis value.Results:1.The scores of visuospatial,attension,language,abstraction,delayed recall and total Mo CA scores in VCI group were significantly lower than the control group(all P<0.05).The levels of serum AngⅡ,ET-1 and u AGT inereased,while serum ADPN decreased in group VCI as compared to the control group(all P<0.05).2.The levels of serum AngⅡ(r=-0.200)、ET-1(r=-0.289)and u AGT(r=-0.233)were negatively,while serum ADPN was positively(r=-0.324)correlated with the total Mo CA score as indicated by Pearson correlation analysis(all P<0.05).3.Logistic regression analysis showed that duration of hypertension,the mean systolic blood pressure,homocysteine,uric acid,AngⅡ,ET-1,u AGT is the risk factor for cognitive dysfunction(P<0.05),the years of education and serum ADPN are protective factors of cognitive dysfunction(P<0.05).4.The area under ROC curve of serum angiotensin Ⅱ,endothelin-1,adiponectin and urinary angiotensinogen were 0.667、0.668、0.663、0.686 respectively.Conclusion:1.The overall cognitive function,visuospatial and executive function,attention,language,abstraction and delayed memory of the elderly patients with cognitive dysfunction of essential hypertension were impaired to different degrees,Analysis and intervention of risk factors of VCI in elderly patients with essential hypertension can help to delay the occurrence and progression of cognitive impairment.2.Cognitive dysfunction in elderly patients with essential hypertension is close to the level of serum Ang Ⅱ,ET-1,ADPN and u AGT,clinical detection of the above indicators can assess the degree of cognitive impairment to a certain extent.