MAGNETIC-RESONANCE-IMAGING CEREBRAL ABNORMALITIES AND NEUROPSYCHOLOGIC TEST-PERFORMANCE IN ELDERLY HYPERTENSIVE SUBJECTS - A CASE-CONTROL STUDY

Objective: To search for a morphologic basis of cognitive impairment p ossibly associated with arterial hypertension using magnetic resonance imaging and a demanding neuropsychologic test battery. Design: Case-c ontrol comparison with age, length of education, presence of diabetes, and presence of cardiac disease as matching criteria. Setting: Austri an Stroke Prevention Study. Subjects: A total of 89 hypertensive subje cts and 89 control subjects from a subset of 272 volunteers with no ne urologic symptoms undergoing extensive diagnostic workup in a large-sc ale stroke prevention study among randomly selected elderly community members. Main Outcome Measures: Focal brain abnormalities and size of ventricles and cortical sulci as assessed by magnetic resonance imagin g and neuropsychological test scores. Results: Hypertensive subjects m ore commonly showed areas of white matter hyperintensity and moderatel y severe ventricular enlargement compared with controls. While no diff erences were noted between the investigational groups in test results of memory capacity and conceptualization, hypertensive subjects tended to perform worse when assessed for attentional and visuopractical ski lls. These differences became significant when comparing the brain-dam aged subsets of patients and controls with their counterparts without cerebral changes. The pattern and extent of neuropsychologic deficits was similar in hypertensive and normotensive subjects with abnormal ma gnetic resonance imaging scans. Conclusion: Our data strongly suggest the high rate of brain abnormalities among hypertensive subjects as th e cause of their subtle neuropsychological dysfunction.