gms | German Medical Science

Background: Hypertension is the most important risk factor for cerebrovascular events. There is increasing evidence that hypertension also correlates with cognitive impairment and onset of dementia. These important aspects often are not analysed in ambulant setting of the general practitioners office. In an observational study hypertensive patients with increased 10-years-stroke risk will be followed up for 1 year with antihypertensive treatment of losartan

Methods: In a subgroup analyses of about 3000 patients (pts) with 10-years stroke-risk >=20% (estimated by risk-calculator including age, systolic blood pressure; history of: diabetes, smoking, atrial fibrillation, left ventricular hypertrophy, myocardial infarction, coronary heart disease, peripheral arterial disease, heart failure) the cognitive function was estimated by performing a screening with "c.I.-test" (cerebral insufficiency; published by S. Lehrl 1994) (in GP and internists- offices). Additional several risk parameters (blood pressure, BMI, cholesterol, hs-CRP, microalbuminuria (MAU)) were assessed.

Results: Only 1/3 of all patients showed normal results in the c.I-test. In all other patients an impairment of cognitive function was indicated by the c.I.-test. There is an increasing percentage of pathological test results with increasing 10-years-stroke-risk, increasing age, history of diabetes mellitus, fibrinogen. In non-diabetics pathologic c.I-tests is associated with increase of blood-glucose, MAU and elevated systolic blood pressure.

Conclusion: Cognitive impairment is very common in patients with hypertension and elevated stroke-risk -especially in diabetics-. In long term-follow-up the effect of losartan-based antihypertensive treatment on stroke-risk and cognitive function will be analysed.