Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study

Abstract Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of t...

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Autores principales:	Pedro Pallangyo, Zabella S. Mkojera, Makrina Komba, Lucy R. Mgopa, Smita Bhalia, Henry Mayala, Salma Wibonela, Nsajigwa Misidai, Happiness J. Swai, Jalack Millinga, Ester Chavala, Peter R. Kisenge, Mohamed Janabi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cognitive dysfunction Cognitive impairment Cognitive decline Cognitive deficits Arterial hypertension Systemic hypertension Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/22f87c338b614b4dab70b65524df9a3f
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spelling	oai:doaj.org-article:22f87c338b614b4dab70b65524df9a3f2021-11-14T12:13:32ZBurden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study10.1186/s12883-021-02467-31471-2377https://doaj.org/article/22f87c338b614b4dab70b65524df9a3f2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02467-3https://doaj.org/toc/1471-2377Abstract Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. Methodology A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4–5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2–2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1–2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0–2.7, p = 0.04) to have independent association with cognitive impairment. Conclusion This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.Pedro PallangyoZabella S. MkojeraMakrina KombaLucy R. MgopaSmita BhaliaHenry MayalaSalma WibonelaNsajigwa MisidaiHappiness J. SwaiJalack MillingaEster ChavalaPeter R. KisengeMohamed JanabiBMCarticleCognitive dysfunctionCognitive impairmentCognitive declineCognitive deficitsArterial hypertensionSystemic hypertensionNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cognitive dysfunction Cognitive impairment Cognitive decline Cognitive deficits Arterial hypertension Systemic hypertension Neurology. Diseases of the nervous system RC346-429
spellingShingle	Cognitive dysfunction Cognitive impairment Cognitive decline Cognitive deficits Arterial hypertension Systemic hypertension Neurology. Diseases of the nervous system RC346-429 Pedro Pallangyo Zabella S. Mkojera Makrina Komba Lucy R. Mgopa Smita Bhalia Henry Mayala Salma Wibonela Nsajigwa Misidai Happiness J. Swai Jalack Millinga Ester Chavala Peter R. Kisenge Mohamed Janabi Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
description	Abstract Background The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. Methodology A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student’s T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. Results A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4–5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2–2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1–2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0–2.7, p = 0.04) to have independent association with cognitive impairment. Conclusion This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.
format	article
author	Pedro Pallangyo Zabella S. Mkojera Makrina Komba Lucy R. Mgopa Smita Bhalia Henry Mayala Salma Wibonela Nsajigwa Misidai Happiness J. Swai Jalack Millinga Ester Chavala Peter R. Kisenge Mohamed Janabi
author_facet	Pedro Pallangyo Zabella S. Mkojera Makrina Komba Lucy R. Mgopa Smita Bhalia Henry Mayala Salma Wibonela Nsajigwa Misidai Happiness J. Swai Jalack Millinga Ester Chavala Peter R. Kisenge Mohamed Janabi
author_sort	Pedro Pallangyo
title	Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
title_short	Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
title_full	Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
title_fullStr	Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
title_full_unstemmed	Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study
title_sort	burden and correlates of cognitive impairment among hypertensive patients in tanzania: a cross-sectional study
publisher	BMC
publishDate	2021
url	https://doaj.org/article/22f87c338b614b4dab70b65524df9a3f
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Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study

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