TOPLINE:
In adults without hypertension at baseline, better cognitive function at baseline was associated with lower odds of incident hypertension after about 6 years of follow-up, with obesity partially mediating the association.
METHODOLOGY:
- Researchers analyzed data from an ongoing prospective study to assess whether cognition was linked to future risk for hypertension and which factors mediated the link.
- They included data of 6755 Hispanic or Latino adults without hypertension from four US metropolitan areas. The median age was 53 years, and 62% were women.
- At the first visit, four neurocognitive tests assessed learning, memory, executive function, and processing speed to derive a global cognitive score. Other relevant parameters were recorded.
- The outcome of interest was incident hypertension at the second visit after a median follow-up of 5.8 years. Hypertension was defined as having blood pressure ≥ 130/80 mm Hg or treatment with an antihypertensive.
- Researchers examined whether unhealthy behaviors including obesity, low physical activity, poor diet, and smoking mediated the link between cognitive function and incident hypertension.
TAKEAWAY:
- By the second visit, 57% of adults developed hypertension. Each 1-SD increase in the global cognitive score was associated with 15% lower odds of incident hypertension (adjusted odds ratio [aOR], 0.85; 95% CI, 0.74-0.98), corresponding to an absolute risk difference of 1.9%.
- Obesity was the only significant mediator between global cognitive scores and the risk for incident hypertension (indirect aOR, 0.95; 95% CI, 0.90-0.99); smoking and low physical activity did not mediate the link.
- Low-quality diet was associated with the risk for hypertension (aOR, 1.39; 95% CI, 1.19-1.64) but did not mediate the association.
- Word fluency, reflecting executive function, was the only individual neurocognitive domain associated with the risk for incident hypertension (aOR, 0.90; 95% CI, 0.82-0.99).
IN PRACTICE:
“These findings indicate that while the individual-level effect of cognition on hypertension risk is modest, improving cognitive health could have a meaningful impact on the population level,” the researchers wrote.
“Interventions that enhance executive function, improve health literacy, or provide behavioral reinforcement may help mitigate the risk of hypertension in cognitively vulnerable populations,” they added.
SOURCE:
This study was led by Gabriela Trifan, Department of Neurology and Rehabilitation, University of Illinois in Chicago. It was published online on December 15, 2025, in Hypertension.
LIMITATIONS:
Many covariates were reported by the adults themselves, which may have introduced recall bias. The results may have differed if more than four cognitive tests were included. Owing to an observational design of the study, researchers could not establish any cause-effect relationships between cognition and hypertension.
DISCLOSURES:
The study received support from multiple sources including the National Institute on Aging and support provided by the National Heart, Lung, and Blood Institute to organizations including the University of North Carolina, University of Miami, and Albert Einstein College of Medicine.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.