Hypertension Coincident with Type 2 Diabetes Worsen Cognitive Function and Arterial Stiffness

Background: The prevalence of concomitant of hypertension (HT) and type 2 diabetes (T2DM) mellitus have increased. However, the additional contribution of high blood pressure to T2DM on cognitive and vascular functions has not been published. Objective: To compare the vascular functions and cognitive function among hypertensive with type 2 diabetic patients, hypertensive patients, and age-match healthy participants. Materials and Methods: Twenty-three hypertensive-diabetic, 25 HT, and 23 sedentary individuals were included in this study. Using the crosssectional design, the vascular functions were assessed with pulse wave velocity (PWV) and flow-mediated dilation (FMD) among the three groups. Global cognitive function tests were performed using Montreal Cognitive Assessment (MOCA). Results: The hypertensive-diabetic group had higher brachial systolic blood pressure (SBP) (p<0.05), mean arterial pressure (MAP) (p<0.05), and pulse pressure (PP) (p<0.05) than the sedentary group. In addition, the hypertensive-diabetic patients had significantly higher PWV and worse cognitive performance than hypertensive and healthy participants (p<0.05) but did not significantly differ in FMD. Arterial stiffness, blood pressure, and fasting blood glucose were associated with level of cognitive performance (p<0.05). Conclusion: Arterial stiffness and blood pressure are a determinant of cognitive functions in hypertensive diabetic subjects but not in individuals with hypertension without diabetes. These results suggested the additional effects of hyperglycemia on high blood pressure might worsen the cognitive functions through higher level of arterial stiffness and blood pressure.