International Psychogeriatrics

Research Article

Vascular risk factors and cognitive function among 3763 participants in the Hypertension in the Very Elderly Trial (HYVET): a cross-sectional analysis

Ruth Petersa1 c1, Nigel Becketta2, Françoise Forettea3, Jaakko Tuomilehtoa4, Craig Ritchiea2, Ivan Waltona5, Adam Waldmana5, Robert Clarkea6, Ruth Poultera1, Astrid Fletchera7 and Christopher Bulpitta1

a1 Care of the Elderly, Imperial College Faculty of Medicine, London, U.K.

a2 Imperial College Faculty of Medicine, London, U.K.

a3 Le Groupe Hospitalier Broca, Paris, France

a4 National Public Health Institute, Helsinki, Finland

a5 Imperial College Healthcare NHS Trust, London, U.K.

a6 Clinical Trials Research Unit, University of Oxford, U.K.

a7 Department of Epidemiology and Population Heath, London School of Hygiene and Tropical Medicine, London, U.K.

ABSTRACT

Background: It is well known that the global population is aging and that those over the age of 80 are the fastest growing part of this expansion. Also known is that prevalence of hypertension and cognitive decline both increase with increasing age.

Method: The Hypertension in the Very Elderly Trial (HYVET) was a double blind placebo-controlled trial of antihypertensive treatment (indapamide SR 1.5 mg ± perindopril 2–4 mg) and recruited only those hypertensives who were aged 80 or over and were without a diagnosis of dementia at baseline. Systolic blood pressure had to be in the range 160–199 mmHg and diastolic pressure <110 mmHg. Cognitive function was assessed at baseline using the Mini-mental State Examination prior to randomization into the trial. Also collected at baseline was information relating to sociodemographic, clinical, cardiovascular and biochemical factors which may impact upon cognitive function. This paper reports on the baseline cognitive function data from the HYVET trial and its relationship to these factors.

Results: The mean age of the 3763 HYVET participants who had full cognitive function data at baseline was 83.6 years; 60 percent were female. The median MMSE score at baseline was 26 and, in multivariate analyses, higher at younger age, with male gender, higher educational level, having higher creatinine, higher total cholesterol and lower high-density lipoprotein cholesterol.

Conclusions: This is the first such study to examine a large number of very elderly hypertensives and it shows some similar patterns to those seen in younger elderly groups.

(Received August 19 2008)

(Revised September 25 2008)

(Revised October 07 2008)

(Accepted October 08 2008)

Correspondence:

c1 Correspondence should be addressed to: Dr. Ruth Peters, Care of the Elderly, Imperial College Faculty of Medicine, Du Cane Rd, London W12 0NN, U.K. Tel. +44 (0)20 83833959; Fax. +44 (0)20 83833378. Email: r.peters@imperial.ac.uk.