Dec. 11, 2001 ST. PAUL, MN -- A multicenter study of 13,600 patients found a correlation between cognitive impairment and heart failure among older patients. This finding adds to the growing body of evidence that arterial hypotension (abnormally low blood pressure) is associated with an increased risk of dementia. The study is reported in the current issue of Neurology, the scientific journal of the American Academy of Neurology. Of the participants in the two-year study, 1,583 had heart failure. Among this group with heart failure, 26 percent had symptoms of cognitive impairment, whereas 19 percent of the subjects without heart failure suffered cognitive impairment.
The study was conducted throughout Italy with 81 hospitals participating, according to study author Giuseppe Zuccalà, MD, chair of gerontology at the Catholic University of the Sacred Heart in Rome.
"We assessed whether arterial hypotension might be associated with cognitive impairment among older subjects with heart failure," said Zuccalà. "Arterial hypotension has been associated with increased risk of dementia in some large prospective studies, but it is still controversial. On the other hand, cognitive impairment is a common, potentially reversible condition among older patients with heart failure and depressed left ventricular function."
The study results found that systolic blood pressure levels below 130 could predict cognitive impairment among participants with heart failure. Just having low blood pressure alone was not a predictor of cognitive impairment, Zuccalà said.
The study concluded that, as hypotension might also be caused or aggravated by pharmacological treatment, routine management of heart failure should include assessment of cognitive performance to early detect any sign of cognitive dyfunction.
The researchers used the database of the Gruppo Italiano di Farmacoepidemiologia nell'Anziano (GIFA), a collaborative study of adverse drug reactions of hospitalized patients. The study was partially supported by a grant from the National Research Council.
The American Academy of Neurology, an association of more than 17,500 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. For more information about the American Academy of Neurology, visit its web site at http://www.aan.com.
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