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Abstract: PO1795

Carotid Plaque Characteristics and Incident Cognitive Impairment in Hypertensive Adults

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Gregg, L Parker, Baylor College of Medicine, Houston, Texas, United States
  • Beddhu, Srinivasan, University of Utah Health, Salt Lake City, Utah, United States
  • Boucher, Robert E., University of Utah Health, Salt Lake City, Utah, United States
  • Kurella Tamura, Manjula, Stanford Medicine, Stanford, California, United States
  • Yuan, Chun, University of Washington, Seattle, Washington, United States
  • Sun, Jie, University of Washington, Seattle, Washington, United States
  • Balu, Niranjan, University of Washington, Seattle, Washington, United States
  • Pajewski, Nicholas M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Williamson, Jeff D., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
  • Navaneethan, Sankar D., Baylor College of Medicine, Houston, Texas, United States
Background

Carotid atherosclerosis is associated with cognitive impairment. We investigated associations of plaque characteristics on carotid magnetic resonance imaging (MRI) with the development of mild cognitive impairment (MCI) or probable dementia.

Methods

In an ancillary study to the Systolic Blood Pressure Intervention Trial (SPRINT), carotid plaque was identified by MRI and characterized as having a lipid-rich necrotic core (NC) or calcification. In the parent study, adjudicated MCI and probable dementia were adjudicated on the basis of neuropsychological testing and proxy reports of cognition-related decline in functional status. We related baseline plaque presence and characteristics of NC or calcification with the incidence of MCI/probable dementia at 3 years of follow-up.

Results

Of 465 participants, 137 (29.5%) had NC plaque. Those with NC plaque were older and more likely to have cardiovascular disease than those without NC plaque. There were 38 MCI/probable dementia outcomes in the entire cohort over 2220 person-years of follow-up. The incidence (95% CI) of a composite outcome of MCI or probable dementia at 3 years was 12.0% (7.5, 18.9) in the NC group and 7.0% (4.6, 10.4) in the no NC group with an absolute risk difference of 5.1% (95% CI -1.2, 11.3, P=0.11). With further adjustment, the absolute risk difference attenuated but the point estimate remained high (Figure). Results for the presence of any plaque or calcified plaque with MCI/probable dementia are also summarized in the Figure.

Conclusion

We observed large differences in risk for MCI/probable dementia associated with the presence vs. absence of NC plaques, but the significance of this finding is uncertain due to the small number of incident cases of cognitive impairment. Nonetheless, our observations indicate the need to study NC plaque as a novel and potentially more relevant marker of vascular health in future studies of cognitive impairment in hypertensive adults.

Funding

  • NIDDK Support