Subcortical ischaemic changes in young hypertensive patients: frequency, effect on cognitive performance and relationship with markers of endothelial and haemostatic activation

Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic ac...

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Published in:	European journal of neurology Vol. 14; no. 11; pp. 1222 - 1229
Main Authors:	Consoli, D., Carlo, A. Di, Inzitari, D., Lucia, D. De, Lamassa, M., D'Avino, M., Baldereschi, M., Muto, M., Mandarino, A., Napolitano, M., Romano, M. F., Caruso, D.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Publishing Ltd 01-11-2007
Subjects:	Adult Age Factors Biomarkers - blood blood pressure Brain - metabolism Brain - pathology Brain Ischemia - blood Brain Ischemia - pathology Brain Ischemia - psychology cerebral small vessels disease cognition Cognition - physiology endothelial dysfunction Endothelium, Vascular - metabolism Endothelium, Vascular - pathology Female Hemostasis - physiology Humans Hypertension - blood Hypertension - pathology Hypertension - psychology magnetic resonance imaging Magnetic Resonance Imaging - methods Male Middle Aged Neuropsychological Tests
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Abstract	Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age ≤54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non‐hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 ± 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups (P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end‐organ damage, underscoring the relevance of treating hypertension at younger age.
AbstractList	Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age ≤54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non‐hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 ± 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups (P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end‐organ damage, underscoring the relevance of treating hypertension at younger age. Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age <or=54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non-hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 +/- 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups (P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end-organ damage, underscoring the relevance of treating hypertension at younger age. Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age ≤54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non‐hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 ± 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups ( P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end‐organ damage, underscoring the relevance of treating hypertension at younger age. Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age <or=54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non-hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 +/- 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups (P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end-organ damage, underscoring the relevance of treating hypertension at younger age. Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging (MRI), the possible effect on cognition of these patients, and the role of plasma markers known as indicators of endothelial and haemostatic activation. Inclusion criteria were age less than or equal to 54 years, hypertension for at least 2 years and absence of cerebrovascular disease or other conditions possibly related to SIC. Patients with SIC at MRI and two control groups (matched for age, sex and education) of hypertensive patients without SIC and non-hypertensive healthy subjects underwent an extensive neuropsychological examination and evaluation of plasma markers. Amongst the 200 patients evaluated, 50 (25%) showed SIC at MRI. Mean age was 48.4 plus or minus 4.8 years. Compared with both control groups, hypertensive patients with SIC performed significantly worse in general cognition, attention, memory and executive functions. Moreover, they showed significantly more often increased levels of all plasma markers compared with healthy controls, and of von Willebrand factor (vWF) compared with both control groups (P < 0.001). In young hypertensive patients SIC are frequent, related to a worse cognitive performance and endothelial dysfunction. Our findings suggest vWF as marker of end-organ damage, underscoring the relevance of treating hypertension at younger age.
Author	Napolitano, M. Inzitari, D. Consoli, D. Mandarino, A. Caruso, D. D'Avino, M. Lucia, D. De Romano, M. F. Lamassa, M. Baldereschi, M. Muto, M. Carlo, A. Di
Author_xml	– sequence: 1 givenname: D. surname: Consoli fullname: Consoli, D. organization: Unit of Neurology Jazzolino Hospital, Vibo Valentia, Italy – sequence: 2 givenname: A. Di surname: Carlo fullname: Carlo, A. Di organization: Institute of Neurosciences, ILSA Study, Italian National Research Council, Florence, Italy – sequence: 3 givenname: D. surname: Inzitari fullname: Inzitari, D. organization: Department of Neurological and Psychiatric Sciences, University of Florence, Italy – sequence: 4 givenname: D. De surname: Lucia fullname: Lucia, D. De organization: General Hospital, Second University of Naples, Naples, Italy – sequence: 5 givenname: M. surname: Lamassa fullname: Lamassa, M. organization: Department of Neurological and Psychiatric Sciences, University of Florence, Italy – sequence: 6 givenname: M. surname: D'Avino fullname: D'Avino, M. organization: Unit of Neurology, Cardarelli Hospital, Naples, Italy – sequence: 7 givenname: M. surname: Baldereschi fullname: Baldereschi, M. organization: Institute of Neurosciences, ILSA Study, Italian National Research Council, Florence, Italy – sequence: 8 givenname: M. surname: Muto fullname: Muto, M. organization: Unit of Neuroradiology, Cardarelli Hospital, Naples, Italy – sequence: 9 givenname: A. surname: Mandarino fullname: Mandarino, A. organization: Unit of Neurology, Cardarelli Hospital, Naples, Italy – sequence: 10 givenname: M. surname: Napolitano fullname: Napolitano, M. organization: General Hospital, Second University of Naples, Naples, Italy – sequence: 11 givenname: M. F. surname: Romano fullname: Romano, M. F. organization: Unit of Neurology Jazzolino Hospital, Vibo Valentia, Italy – sequence: 12 givenname: D. surname: Caruso fullname: Caruso, D. organization: Unit of Hypertension, Cardarelli Hospital, Naples, Italy
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Snippet	Information on subcortical ischaemic changes (SIC) in young hypertensive patients is scarce. We evaluated the frequency of SIC at magnetic resonance imaging...
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SubjectTerms	Adult Age Factors Biomarkers - blood blood pressure Brain - metabolism Brain - pathology Brain Ischemia - blood Brain Ischemia - pathology Brain Ischemia - psychology cerebral small vessels disease cognition Cognition - physiology endothelial dysfunction Endothelium, Vascular - metabolism Endothelium, Vascular - pathology Female Hemostasis - physiology Humans Hypertension - blood Hypertension - pathology Hypertension - psychology magnetic resonance imaging Magnetic Resonance Imaging - methods Male Middle Aged Neuropsychological Tests
Title	Subcortical ischaemic changes in young hypertensive patients: frequency, effect on cognitive performance and relationship with markers of endothelial and haemostatic activation
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