Cognitive Disorders in Patients with Hypertension: Are There Gender Differences?
Background: Given the profound differences between women and men, there is a need to study gender as a vital variable and factor in blood pressure regulation, control, and treatment. The level of anxiety and depression, which significantly affect the psychological characteristics and patients' quality of life, and the status of the autonomic nervous system represent a rather significant layer of hypertension problems due to its specificity, accumulating its medical, social, gender, and humanitarian aspects, which are related to sexual characteristics.
Material and Methods: The study results are based on the data of a comprehensive examination of 185 working patients with controlled hypertension (H) stage II. According to the neuro-psychological testing on MMSE, МоСА and Life Quality scales, 157 people with various severity cognitive disorders (CD) were found. There were 87 (55.4 %) women and 70 (44.6 %) men among them, and the average age [M(SD)] was 52.3 (8.2) years; the average duration of H was 10 (8-12 years). The comparison and control groups were adequate for the purpose. The standard methods of parametric and non-parametric statistics processed the obtained data.
Results: As a result of the study, significant differences were found in patients with hypertension and CD of both sexes compared with healthy individuals and patients with hypertension without cognitive impairment in relation to the daily blood pressure profile (VAR SBP, VAR DBP) both during the day and at night. The females, even middle-aged, with controlled hypertension but high systolic blood pressure variability, have a substantial risk of developing CD. Male patients with hypertension, even in the absence of CD, are more prone to depression, according to the HADS scale. In the presence of hypertension with CD, they are characterized by significantly worse personal-role physical and emotional functioning compared to female patients on the life quality scale. The often irresponsible attitude of men to the doctor's advice and regular antihypertensive treatment probably plays a significant role in the formation of gender differences in the quality of life of patients with hypertension and CD.
Conclusion: It is necessary to ensure early diagnosis and monitoring of CD as a marker of brain damage due to hypertension and determine the level of anxiety and depression, which significantly affect the psychological characteristics and quality of life even of patients with controlled hypertension, regardless of gender. However, middle-aged women, even with controlled hypertension but high SBP variability, have a priority risk of CD development.
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