Hypertension with Hyperhomocysteinemia Increases the Risk of Early Cognitive Impairment after First-Ever Ischemic Stroke.

Abstract:

BACKGROUND:Hypertension and hyperhomocysteinemia (HHcy) are independent risk factors of stroke and are associated with each other. Although evidence suggests that they are related to cognitive impairment, the relationship between hypertension accompanied with HHcy and poststroke cognitive impairment (PSCI) is unclear. OBJECTIVE:To define the relationship between hypertension with HHcy and early cognitive impairment after acute cerebral infarction. MATERIALS AND METHODS:Our study enrolled 232 patients with acute first-ever ischemic stroke. Patients were assigned to 3 groups by blood pressure and homocysteine (Hcy) levels: hypertension with HHcy, simple hypertension, or control. Cognition was assessed by the Montreal cognitive assessment at admission and at 3- and 6-month follow-ups. RESULTS:The hypertension with HHcy group exhibited the highest incidence of early cognitive impairment (simple hypertension: p = 0.000; control: p = 0.000). This group also had lower visual space/executive scores than the simple hypertension group (p = 0.000) and lower delayed recall scores than the control group (p = 0.011). Multivariate analysis showed that hypertension with HHcy (OR 7.797; 95% CI 2.917-20.843; p = 0.000), the level of serum Hcy (OR 1.063; 95% CI 1.109-1.109; p = 0.005), education years (OR 0.797; 95% CI 0.722-0.880; p = 0.000), and Fazekas scale of leukoaraiosis (OR 1.648; 95% CI 1.239-2.191; p = 0.001) were independent influencing factors of early PSCI; however, simple hypertension (OR 1.183, 95% CI 0.208-6.737; p = 0.850) and simple HHcy (OR 1.112, 95% CI 0.181-6.810; p = 0.909) were not. CONCLUSION:Patients with both hypertension and HHcy are at an increased risk of early cognitive impairment after acute first-ever ischemic stroke.

journal_name

Eur Neurol

journal_title

European neurology

authors

Lu ZH,Li J,Li XL,Ding M,Mao CJ,Zhu XY,Liu CF

doi

10.1159/000504704

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

75-85

issue

4-6

eissn

0014-3022

issn

1421-9913

pii

000504704

journal_volume

82

pub_type

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