Relationship between Hypertension and Cognitive Impairment in Older Adults: A Cross-Sectional Study

Abstract

Background: Hypertension is one of the most common chronic-degenerative diseases in the world. It leads to systemic vascular damage, resulting in complications across various organ systems, including the cardiovascular, ophthalmologic, renal, and neurological systems. Neurological damage secondary to hypertension is mediated by several mechanisms, such as endothelial injury, inflammation, and alterations in the blood–brain barrier, among others. Conditions such as mild cognitive impairment (MCI) and dementia can result from these disturbances. In this context, given the high prevalence of hypertension among older adults, it is of utmost importance to understand its relationship with cognitive alterations in this population. Objective: The objective of the present study was to determine the relationship hypertension and MCI in adults aged 60 years and older attending the outpatient clinic of the Guanajuato General Hospital. Study Design: Cross-sectional, observational, analytical, quantitative, and prolective study. Study site and date: The study was conducted in the outpatient clinic of the Guanajuato General Hospital between January and June 2025. Methodology: The study included a sample of 124 participants aged ≥ 60 years. Participants were classified with or without hypertension. To assess de presence or absence of MCI the MoCA® test was administered. The quantitative variables like age, weight, height, blood pressure, body mass index and waist circumference were measured, along with categorical variables including sex, marital status, educational level, and comorbidities. The relationship between hypertension and MCI was analyzed. In addition, the scores of the different MoCA® test domains were compared between hypertensive and non-hypertensive participants. Results: A total of 60.48% of participants presented hypertension. MCI was observed in 79.67% of hypertensive individuals and in 46.94% of non-hypertensive individuals. Logistic regression analysis showed a significant association between hypertension and MCI (OR: 4.17; 95% CI: 1.90–9.16; P = 0.0003). The cognitive domains affected were visuospatial/executive function, attention, language, abstraction, and orientation (P < .05). Conclusion: Hypertension was significantly associated with MCI, suggesting possible early vascular neurocognitive damage. These findings highlight the importance of timely screening and adequate blood pressure control.