Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial
BackgroundObesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is corre...
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-10-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.117.005561 |
| _version_ | 1818312266032873472 |
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| author | Jun Zhang Genfu Tang Haiqun Xie Binyan Wang Mingli He Jia Fu Xiuli Shi Chengguo Zhang Yong Huo Xiping Xu Kai Wang |
| author_facet | Jun Zhang Genfu Tang Haiqun Xie Binyan Wang Mingli He Jia Fu Xiuli Shi Chengguo Zhang Yong Huo Xiping Xu Kai Wang |
| author_sort | Jun Zhang |
| collection | DOAJ |
| description | BackgroundObesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is correlated with longitudinal cognitive performance in hypertensive adults. Methods and ResultsThe analysis included 16 791 patients in the CSPPT who received at least 2 cognitive assessments by the Mini‐Mental State Examination (MMSE) during the follow‐up (median, 4.5 years; interquartile range, 4.2–4.8 years). Outcomes included changes in MMSE scores and cognitive impairment (defined as MMSE score less than education‐specific cutoff point). A marked reduction in MMSE scores at the final (compared with at the 1‐year) follow‐up was apparent in both men (n=4838; mean [SD] score, 0.41 [3.62]) and women (n=7190; mean [SD] score, 1.07 [4.61]; both P<0.001). Analysis using a mixed‐effects model revealed an association between higher body mass index with less MMSE decline, even after controlling for demographics and comorbidities (men, β=0.0134 [SE, 0.0036]; women, β=0.0133 [SE, 0.0034]; both P<0.001). A total of 1037 men (15.3%) and 3317 women (33.1%) developed cognitive impairment. In multivariable Cox regression analyses, being obese in men (11.3% versus 18.0%; hazard ratio, 0.75; 95% confidence interval, 0.60–0.94) and women (30.1% versus 36.5%; hazard ratio, 0.82; 95% confidence interval, 0.74–0.91) was a protective factor against cognitive impairment compared with normal body mass index. ConclusionsHigher adiposity is independently associated with slower cognitive decline in Chinese hypertensive adults. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885 CSPPT. |
| first_indexed | 2024-12-13T08:15:07Z |
| format | Article |
| id | doaj.art-89f1fd09978046df9e7e45ba6a447863 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T08:15:07Z |
| publishDate | 2017-10-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-89f1fd09978046df9e7e45ba6a4478632022-12-21T23:54:07ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-10-0161010.1161/JAHA.117.005561Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention TrialJun Zhang0Genfu Tang1Haiqun Xie2Binyan Wang3Mingli He4Jia Fu5Xiuli Shi6Chengguo Zhang7Yong Huo8Xiping Xu9Kai Wang10Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaInstitute for Biomedicine, Anhui Medical University, Hefei, ChinaDepartment of Neurology, The Affiliated Foshan Hospital of Sun Yat‐sen University, Foshan, ChinaInstitute for Biomedicine, Anhui Medical University, Hefei, ChinaDepartment of Neurology, The First People's Hospital of Lianyungang, Lianyungang, ChinaDepartment of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaDepartment of Neurology, The Affiliated Foshan Hospital of Sun Yat‐sen University, Foshan, ChinaDepartment of Cardiology, Peking University First Hospital, Beijing, ChinaInstitute for Biomedicine, Anhui Medical University, Hefei, ChinaDepartment of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, ChinaBackgroundObesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is correlated with longitudinal cognitive performance in hypertensive adults. Methods and ResultsThe analysis included 16 791 patients in the CSPPT who received at least 2 cognitive assessments by the Mini‐Mental State Examination (MMSE) during the follow‐up (median, 4.5 years; interquartile range, 4.2–4.8 years). Outcomes included changes in MMSE scores and cognitive impairment (defined as MMSE score less than education‐specific cutoff point). A marked reduction in MMSE scores at the final (compared with at the 1‐year) follow‐up was apparent in both men (n=4838; mean [SD] score, 0.41 [3.62]) and women (n=7190; mean [SD] score, 1.07 [4.61]; both P<0.001). Analysis using a mixed‐effects model revealed an association between higher body mass index with less MMSE decline, even after controlling for demographics and comorbidities (men, β=0.0134 [SE, 0.0036]; women, β=0.0133 [SE, 0.0034]; both P<0.001). A total of 1037 men (15.3%) and 3317 women (33.1%) developed cognitive impairment. In multivariable Cox regression analyses, being obese in men (11.3% versus 18.0%; hazard ratio, 0.75; 95% confidence interval, 0.60–0.94) and women (30.1% versus 36.5%; hazard ratio, 0.82; 95% confidence interval, 0.74–0.91) was a protective factor against cognitive impairment compared with normal body mass index. ConclusionsHigher adiposity is independently associated with slower cognitive decline in Chinese hypertensive adults. Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885 CSPPT.https://www.ahajournals.org/doi/10.1161/JAHA.117.005561adipositybody mass indexcognitive declinehypertensionwaist circumference |
| spellingShingle | Jun Zhang Genfu Tang Haiqun Xie Binyan Wang Mingli He Jia Fu Xiuli Shi Chengguo Zhang Yong Huo Xiping Xu Kai Wang Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease adiposity body mass index cognitive decline hypertension waist circumference |
| title | Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial |
| title_full | Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial |
| title_fullStr | Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial |
| title_full_unstemmed | Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial |
| title_short | Higher Adiposity Is Associated With Slower Cognitive Decline in Hypertensive Patients: Secondary Analysis of the China Stroke Primary Prevention Trial |
| title_sort | higher adiposity is associated with slower cognitive decline in hypertensive patients secondary analysis of the china stroke primary prevention trial |
| topic | adiposity body mass index cognitive decline hypertension waist circumference |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.117.005561 |
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