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Background: Masked hypertension is described as high ambulatory blood pressure measurements (ABPM) where office blood pressure measurements are normal. Effect of hypertension on cognitive functions is well known. However, the effect of masked hypertension on cognitive functions is still unknown. The aim of this study is to examine the relationship between masked hypertension and cognitive functions.
Methods: One hundred-two normotensive patients admitted to the Geriatric Medicine outpatient clinic were included. Exclusion criteria were hypertension, dementia, major depression, and usage of antihypertensive medication. All patients underwent ABPM procedures and average daytime blood pressure, mean blood pressure at night and the 24-hours average blood pressure measurements were recorded. Comprehensive geriatric assessment tests and neuropsychological tests were administered. The diagnosis of masked hypertension was based on the definitions in the 2013 guideline of the European Society of Cardiology (ESC).
Results: 44 patients (43%) were diagnosed with masked hypertension. Patients with masked hypertension had significantly lower scores on Mini-Mental State Examination (MMSE) test, Quick Mild Cognitive Impairment Test (QMCI) and Categorical Fluency Test than the normotensive patients (p = 0.011; p = 0.046; and p = 0.004; respectively). Montreal Cognitive Assessment Scale (MOCA) test score was lower in masked hypertension, although this was not statistically significant.
Conclusions: This study shows that geriatric patients with masked hypertension, compared to normotensive patients have decreased cognitive functions. ABPM should be performed to normotensive geriatric patients for detecting possible masked hypertension and in patients with masked hypertension, cognitive assessment is essential to diagnose possible cognitive dysfunction at early stage.
Mustafa Cankurtaran is the head of the Geriatric Medicine Department in Hacettepe University. He received his medical degree at 1997 from Hacettepe University. He completed his Internal Medicine Residency in 2001 and Geriatric Medicine residency in 2004 at the same university. He is currently working as a lecturer and academician in Hacettepe University Department of Internal Medicine Division of Geriatric Medicine. He has published more than 50 papers in reputed journals. His special interest is in Alzheimer’s disease, malnutrition, pain management, and other geriatric syndromes.
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