University of Oulu

Xu, Y., Bouliotis, G., Beckett, N.S. et al. Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension. J Hum Hypertens 37, 307–312 (2023).

Left ventricular hypertrophy and incident cognitive decline in older adults with hypertension

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Author: Xu, Ying1,2; Bouliotis, George3; Beckett, Nigel S.4;
Organizations: 1Neuroscience Research Australia, Margarete Ainsworth Building, Barker Street, Randwick, NSW, 2031, Australia
2University of New South Wales, Sydney, NSW, 2052, Australia
3Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
4Guys and St Thomas’ NHS Trust, London, UK
5Centre for Life-Course Health Research/Geriatrics, University of Oulu, Oulu, Finland
6Medical Research Centre Oulu, Oulu University Hospital, Oulu, Finland
7The George Institute for Global Health, Level 5, 1 King St, Newtown, NSW, 2042, Australia
8The George Institute for Global Health at Peking University Health Science Centre, Level 18, Tower B, Horizon Tower, No. 6 Zhichun Rd, Haidian District, Beijing, 100088, P.R. China
9Neurology Department, Sydney Local Area Health District, Royal Prince Alfred Hospital, Camperdown, NSW, 2050, Australia
10Imperial College London, London, W2 1PG, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Springer Nature, 2023
Publish Date: 2023-09-15


The association between raised blood pressure and increased risk of subsequent cognitive decline is well known. Left ventricular hypertrophy (LVH), as a marker of hypertensive target organ damage, may help identify those at risk of cognitive decline. We assessed whether LVH was associated with subsequent cognitive decline or dementia in hypertensive participants aged ≥80 years in the randomized, placebo-controlled Hypertension in the Very Elderly Trial. LVH was assessed using 12-lead electrocardiography (ECG) based on the Cornell Product (CP-LVH), Sokolow-Lyon (SL-LVH), and Cornell Voltage (CV-LVH) criteria. The Mini-Mental State Examination (MMSE) was used to assess cognitive function at baseline and annually. A fall in MMSE to <24 or an annual fall of >3 points were defined as cognitive decline and triggered dementia screening (Diagnostic Statistical Manual IV). Death was defined as a competing event. Fine-Gray regression models were used to examine the relationship between baseline LVH and cognitive outcomes. There were 2645 in the analytical sample, including 201 (7.6%) with CP-LVH, 225 (8.5%) SL-LVH and 251 (9.5%) CV-LVH. CP-LVH was associated with increased risk of cognitive decline, subdistribution hazard ratio (sHR)1.3 (95% confidence interval (CI) 1.01–1.67) in multivariate analyses. SL-LVH and CV-LVH were not associated with cognitive decline (sHR1.06 (95% CI 0.82–1.37) and sHR1.13 (95% CI 0.89–1.43), respectively). LVH was not associated with dementia. LVH may be related to subsequent cognitive decline, but evidence was inconsistent depending on ECG criterion and there were no associations with incident dementia. Additional work is needed to understand the relationships between blood pressure, LVH assessment and cognition.

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Series: Journal of human hypertension
ISSN: 0950-9240
ISSN-E: 0950-9240
ISSN-L: 0950-9240
Volume: 37
Issue: 4
Pages: 307 - 312
DOI: 10.1038/s41371-022-00681-1
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the National Health and Medical Research Council Project Grant (APP1160373). Open Access funding enabled and organized by CAUL and its Member Institutions.
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