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 Neuroljournal_title
European neurologyauthors
Lu ZH,Li J,Li XL,Ding M,Mao CJ,Zhu XY,Liu CFdoi
10.1159/000504704subject
Has Abstractpub_date
2019-01-01 00:00:00pages
75-85issue
4-6eissn
0014-3022issn
1421-9913pii
000504704journal_volume
82pub_type
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journal_title:European neurology
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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