Evaluation of blood pressure variability and serum uric acid in cognitive impairment associated with H-type hypertension

WEI Xue-ke; YANG Qing-cheng; GUO Yan-ping

doi:10.13820/j.cnki.gdyx.20242751

Abstract：Objective To investigate changes in blood pressure variability(BPV)and serum uric acid(SUA)levels in patients with H-type hypertension complicated by cognitive impairment and to evaluate their predictive value.Methods A total of 102 patients with H-type hypertension between December 1,2022,and December 31,2023,were enrolled.Based on cognitive function,patients were divided into a cognitive impairment group and a non-impairment group.Dynamic blood pressure monitoring was performed,recording daytime,nighttime,and 24-hour systolic(SBP)and diastolic blood pressure(DBP).Blood pressure variability indices including 24-hour SBP coefficient of variation(24 h SBP-CV),24-hour DBP coefficient of variation(24 h DBP-CV),and 24-hour mean pulse pressure(24 h MPP)were calculated.SUA levels were measured and compared between the groups.Spearman correlation analysis was used to assess the relationship between BPV/SUA and Mini-Mental State Examination(MMSE)scores.Logistic multiva-riate regression was used to identify factors associated with cognitive impairment.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of BPV and SUA for cognitive impairment in H-type hypertension.Re-sults The cognitive impairment group had significantly higher age,disease duration,24 h SBP-CV,24 h MPP,average 24 h SBP and DBP,daytime average SBP,nighttime average DBP,SUA,and homocysteine(Hcy)levels than the non-impairment group(P＜0.05).Spearman analysis showed that 24 h SBP-CV,24 h MPP,nighttime average DBP,and Hcy were negatively correlated with MMSE scores(r=-0.331,-0.318,-3.622,-3.561;P＜0.05),while SUA was positively correlated(r=0.344,P＜0.05).Generalized linear regression identified hypertension stage Ⅲ,age,dis-ease duration,Hcy,24 h SBP-CV,24 h MPP,and nighttime average DBP as risk factors for cognitive impairment,while SUA was a protective factor(P＜0.05).ROC analysis showed that the area under the curve(AUC)for predicting cognitive impairment was 0.699 for 24 h SBP-CV,0.691 for 24 h MPP,and 0.706 for SUA.The combination of these three indicators yielded the highest AUC of 0.833,significantly higher than any single indicator(P＜0.05).Conclusion 24 h SBP-CV,24 h MPP,and SUA are closely associated with cognitive impairment in H-type hypertension and have significant predictive value.