Obesity and Dyslipidemia as Risk Factors of Vascular Cognitive Impairment in Adult Hypertensive Nigerian

Hypertension impairs the cerebral vasculature resulting in vascular cognitive impairment [VCI]. The role of obesity and plasma lipids shown as risk factors in development of VCI in adults with hypertension is unclear and is investigated in this study.

Normoglycemic individuals [n=216] aged 40-75 years were enrolled into this study between January and December 2019. They included Newly Diagnosed Hypertensives with [NDHCI, n-69] and without Cognitive Impairment [NDH, n-81], age-matched with 66 apparently healthy individuals [Controls]. Anthropometric measures [height, weight, waist circumference [WC], Hip circumference [HC], waist hip rratio [WHR] and body mass index [BMI] and socio-demographic indices, lifestyle and blood pressure were obtained using standard methods. Plasma lipids [Total cholesterol [TC], high density lipoprotein cholesterol [HDL-C], Triglyceride [TG] were determined spectrophotometrically, while low density lipoprotein cholesterol [LDL-C] was calculated using Friedewald formula. Neuropsychological assessment based on cognitive score [CS] was done using community screening instrument for dementia [CSID]. Data were analyzed using statistical package for social sciences [SPSS] software 17.0 version. Analysis of variance [ANOVA] and Post Hoc test were used for comparison of variables while Chi square test was used to find associations between variables. These were considered significant at p<0.05.

The obesity indicators [WHR, WC and BMI] and dyslipidemia indicators [TC, LDL-C and triglyceride] levels were significantly higher in NDHCI [WHR=76.97±0.89, WC=37.67±0.61, BMI=28.09±0.49; TC=206.89±3.91, LDL-C=135.76±3.81, triglyceride=135.38±1.63] and NDH [WHR=70.71 ± 0.10] WC=34.74 ± 0.04,BMI= 28.30 ± 0.49 and TC=192.83 ± 4.28,LDLC= 120.35 ± 3.22,Triglyceride=127.00 ± 2.69] relative to control [WHR=51.99 ± 0.83, WC=32.94 ± 0.22, BMI=23.89 ± 0.30 and TC=104.70 ± 7.19,LDLC= 94.80 ± 1.90,Triglyceride=72.77 ± 3.70], p<0.01. Significantly low cognitive scores were found in NDHCI[3.48±0.38] compared with NDH [18.77±0.50] and control [28.76±0.16], p<0.001. WHR and LDL-C had inverse relationships with cognitive score in NDH [β= -14.627, p= 0.306] and NDHCI [β= -0.031, p=0.005] respectively. Moreover, WC [β=12.315, p=0.049], HC [β=12.241, p=0.036] and WHR [β=496.374, p=0.043] in NDH group, had a significantly positive relationship with DBP.

Obesity and atherogenic dyslipidaemia may be associated with the progression of hypertension to cognitive impairment in Nigerian hypertensive adults.