Skip to main content
Log in

Hypertension and cognitive function

  • Published:
Journal of Clinical Psychology in Medical Settings Aims and scope Submit manuscript

Abstract

Previous research indicates that blood pressure may impact a variety of cognitive functions, including short-term memory, abstract reasoning, visual-spatial abilities, and attention (Boller, Vrtunski, Mack, & Kim, 1977; Elias, Robbins, Schultz, & Pierce, 1990; Franceschi, Tancredi, Smirne, Mercinelli, & Canal, 1982; Mazzucchiet al., 1986). However, studies which have assessed the cognitive functioning of hypertensive adults have offered conflicting results, particularly when hypertension levels were in the mild range (e.g., Bolleret al., 1977; Eliaset al., 1990; Elias, Wolf, D'Agostino, Cobb, & White, 1993; Farmeret al., 1987, 1990; Franceschiet al., 1982; Pérez-Stable, Coates, Halliday, Gardiner, & Hauck, 1992; Schmidtet al., 1991; Waldstein, Ryan, Manuck, Parkinson, & Bromet, 1991). A number of factors may contribute to the inconsistent findings in this area. Researchers have employed a wide range of neuropsychological instruments to assess varying domains of cognitive function. Sample sizes in some studies have been too small to ensure sufficient power. Finally, studies have employed varying methodological control over potential confounding factors such as concurrent medical conditions, alcohol abuse, psychiatric disorders, or antihypertensive medication. This study compared male veterans with blood pressures in the mildly hypertensive range (n=166) to normotensive veterans (n=176) on neuropsychological measures of verbal fluency, visual-spatial ability, verbal and visual memory, dexterity, attention, and executive functions. Results revealed that, after controlling for differences in education and income, there was no relationship between mild hypertension and combined measures of cognitive performance. The present findings suggest that mild hypertension alone has little effect on cognitive function in adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Benton, A. L., & Hamsher, K. deS. (1976).Manual for the multilingual aphasia examination. Iowa City: University of Iowa.

    Google Scholar 

  • Berg, E. A. (1948). A simple objective technique for measuring flexibility in thinking.Journal of General Psychology, 39 15–22.

    Google Scholar 

  • Blumenthal, J. A., Madden, D. J., Pierce, T. W., Siegel, W. C., & Appelbaum, M. (1993). Hypertension affects neurobehavioral functioning.Psychosomatic Medicine, 55 44–50.

    PubMed  Google Scholar 

  • Boller, F., Vrtunski, B., Mack, J. L., & Kim, Y. (1977). Neuropsychological correlates of hypertension.Archives of Neurology, 34 701–705.

    PubMed  Google Scholar 

  • Bornstein, R. A. (1986). Consistency of intermanual discrepancies in normal and unilateral brain lesion patients.Journal of Consulting and Clinical Psychology, 54(5), 719–723.

    Article  PubMed  Google Scholar 

  • Delis, D. C., Kramer, J. H., Kaplan, E., & Ober, B. A. (1987).Manual for the California Verbal Learning Test. San Antonio, TX: Psychological Corp.

    Google Scholar 

  • Delis, D. C., Cullum, C. M., Butters, N., Cairns, P., & Prifitera, A. (1988). Wechsler Memory Scale-Revised and California Verbal Learning Test: Convergence and divergence.The Clinical Neuropsychologist, 2(2), 188–196.

    Google Scholar 

  • Elias, M. F., & Elias, P. K. (1993). Hypertension affects neurobehavioral functioning: So what's new?Psychosomatic Medicine, 55 51–54.

    PubMed  Google Scholar 

  • Elias, M. F., Robbins, M. A., Schultz, N. R., Jr., & Streeten, D. H. P. (1986). A longitudinal study of neuropsychological test performance for hypertensive and normotensive adults: Initial findings.Journal of Gerontology, 1 503–505.

    Google Scholar 

  • Elias, M. F., Robbins, M. A., Schultz, N. R., Streeten, D. H. P., & Elias, P. K. (1987). Clinical significance of cognitive performance by hypertensive patients.Hypertension, 9 192–197.

    PubMed  Google Scholar 

  • Elias, M. F. Robbins, M. A. Schultz, N. R., Jr., & Pierce, T. W. (1990). Is blood pressure an important variable in research on aging and neuropsychological test performance?Journal of Gerontology: Psychological Sciences, 45(4), 128–135.

    Google Scholar 

  • Elias, M. F., Wolf, P. A., D'Agostino, R. B., Cobb, J., & White, L. R. (1993). Untreated blood pressure level is inversely related to cognitive functioning: The Framingham Study.American Journal of Epidemiology, 138 353–364.

    PubMed  Google Scholar 

  • Farmer, M. E., White, L. R., Abbott, R. D., Kittner, S. J., Kaplan, E., Wolz, M. M., Brody, J. A., & Wolf, P. A. (1987). Blood pressure and cognitive performance.American Journal of Epidemiology, 1103–1114.

  • Farmer, M. E., Kittner, S. J., Abbott, R. D., Wolz, M. M., Wolf, P. A., & White, L. R. (1990). Longitudinally measured blood pressure, antihypertensive medication use, and cognitive performance: The Framingham Study.Journal of Clinical Epidemiology, 43(5), 475–480.

    Article  PubMed  Google Scholar 

  • Franceschi, M., Tancredi, O., Smirne, S., Mercinelli, A., & Canal, N. (1982). Cognitive processes in hypertension.Hypertension, 4 226–229.

    PubMed  Google Scholar 

  • Goldman, H., Kleinman, K. M., Snow, M. Y., Bidus, D. R., & Korol, B. (1974). Correlation of diastolic blood pressure and signs of cognitive dysfunction in essential hypertension.Diseases of the Nervous System, 35 571–572.

    Google Scholar 

  • Goldman, H., Kleinman, K. M., Snow, M. Y., Bidus, D. R., & Korol, B. (1975). Relationship between essential hypertension and cognitive functioning: Effects of biofeedback.Psychophysiology, 569–573.

  • Gronwall, D. M. A., & Sampson, H. (1974).The psychological effects of concussion. Auckland: Auckland University Press.

    Google Scholar 

  • Hair, J. F., Jr., Anderson, R. E., Tatham, R. L., & Black, W. C. (1992).Multivariate data analysis (3rd ed.). New York: Macmillan.

    Google Scholar 

  • Heaton, R. K. (1981).Wisconsin Card Sorting Test manual. FL: Psychological Assessment Resources.

    Google Scholar 

  • Jarvis, P. E., & Barth, J. T. (1984).Halstead-Reitan test battery: An interpretive guide. FL: Psychological Assessment Resources.

    Google Scholar 

  • Kleinman, K. M., Goldman, H., Snow, M. Y., & Korol, B. (1977). Relationship between essential hypertension and cognitive functioning. II. Effects of biofeedback training generalize to non-laboratory environment.Psychophysiology, 14 192–197.

    PubMed  Google Scholar 

  • Klove, H. (1963). Clinical neuropsychology. In F. M. Forster (Ed.).,The medical clinics of North America. New York: Saunders.

    Google Scholar 

  • Lezak, M. D. (1983).Neuropsychological assessment (2nd ed.). New York: Oxford University Press.

    Google Scholar 

  • Llabre, M. M., Ironson, G. H., Spitzer, S. B., Gellman, M. D., Weidler, D. J., & Schneiderman, N. (1988). How many blood pressure measurements are enough? An application of generalizability theory to the study of blood pressure reliability.Psychophysiology, 25(1), 97–106.

    PubMed  Google Scholar 

  • Madden, D. J., & Blumenthal, J. A. (1989). Slowing of memory-search performance in men with mild hypertension.Health Psychology, 8 131–142.

    Article  PubMed  Google Scholar 

  • Matthews, C. G., & Haaland, K. Y. (1979). The effect of symptom duration on cognitive and motor performance in Parkinsonism.Neurology, 29 951–956.

    PubMed  Google Scholar 

  • Mazzucchi, A., Mutti, A., Poletti, A., Ravanetti, C., Novarini, A., & Parma, M. (1986). Neuropsychological deficits in arterial hypertension.Acta Neurologica Scandinavia, 73 619–627.

    Google Scholar 

  • Miller, R. E., Shapiro, A. P., King, H. E., Ginchereau, E. H., & Hosutt, J. A. (1984). Effect of antihypertensive treatment on the behavioral consequences of elevated blood pressure.Hypertension, 6 202–208.

    PubMed  Google Scholar 

  • Montague, E. K., Williams, H. L., Lubin, A., & Gieseking, C. F. (1957). Army tests for assessment of intellectual deficit.U.S. Armed Forces Medical Journal, 8 883–892.

    Google Scholar 

  • Norusis, M. J. (1990).Statistical package for the social sciences: SPSS/PC+ statistics 4.0 for the IBM PC/XT/AT and PS/2. Chicago: SPSS.

    Google Scholar 

  • Osterrieth, P. A. (1944). Le test de copie d'une figure complexe.Archives de Psychologie, 30 206–356.

    Google Scholar 

  • Pentz, C. A., Elias, M. F., Wood, W. G., Schultz, N. A., & Dineen, J. (1979). Relationship of age and hypertension to neuropsychological test performance.Experimental Aging Research, 5 351–372.

    PubMed  Google Scholar 

  • Pérez-Stable, E. J., Coates, T. J., Halliday, R., Gardiner, P. S., & Hauck, W. W. (1992). The effects of mild diastolic hypertension on the results of tests of cognitive function in adults 22 to 59 years of age.Journal of General Internal Medicine, 7 19–25.

    PubMed  Google Scholar 

  • Robbins, M. A., Elias, M. F., Croog, S. H., & Colton, T. (1994). Unmedicated blood pressure levels and quality of life in elderly hypertensive women.Psychosomatic Medicine, 56 251–259.

    PubMed  Google Scholar 

  • Robins, L. N., Helzer, J. E., Croughan, J., & Ratcliff, K. S. (1981). The NIMH Diagnostic Interview Schedule: Its history, characteristics and validity.Archives of General Psychiatry, 38 381–389.

    PubMed  Google Scholar 

  • Schmidt, R., Fazekas, F., Offenbacher, H., Lytwyn, H., Blematl, B., Niederkorn, K., Horner, S., Payer, F., & Freidl, W. (1991). Magnetic resonance imaging white matter lesions and cognitive impairment in hypertensive individuals.Archives of Neurology, 48 417–420.

    PubMed  Google Scholar 

  • Schultz, N. R., Jr., Dineen, J. T., Elias, M. F., Penz, C. A., & Wood, W. G. (1979). WAIS performance for different age groups of hypertensive and control subjects during the administration of a diuretic.Journal of Gerontology, 34 246–253.

    PubMed  Google Scholar 

  • Schultz, N. R., Jr., Elias, M. F., Robbins, M. A., Streeten, D. H. P., & Blakeman, N. (1986). A longitudinal comparison of hypertensives and normotensives on the Wechsler Adult Intelligence Scale: Initial findings.Journal of Gerontology, 41(2), 169–175.

    PubMed  Google Scholar 

  • Shapiro, A. P., Miller, R. E., King, H. E., Ginchereau, E. H., & Fitzgibbon, K. (1982). Behavioral consequences of mild hypertension.Hypertension, 4(3), 355–360.

    PubMed  Google Scholar 

  • Stevens, J. (1986).Applied multivariate statistics for the social sciences. NJ: Lawrence Erlbaum Associates, Inc.

    Google Scholar 

  • Streeten, D. H. P. (1980). Introduction: What is hypertension? In M. F. Elias & D. H. P. Streeten (Eds.),Hypertension and cognitive processes (pp. 3–15). Mount Desert, ME: Beech Hill.

    Google Scholar 

  • Subcommittee of the 1984 Joint National Committee (1985). Hypertension prevalence and the status of awareness, treatment and control in the U.S.Hypertension, 7 457–468.

    Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (1989).Using multivariate statistics (2nd ed.). New York: Harper Collins.

    Google Scholar 

  • U.S. Department of Health & Human Services, Public Health Service, Centers for Disease Control (1989).Health status of Vietnam veterans, Vols. I–V.

  • Waldstein, S. R., Manuck, S. B., Ryan, C. M., & Muldoon, M. F. (1991). Neuropsychological correlates of hypertension: Review and methodologic considerations.Psychological Bulletin, 110(3), 451–468.

    Article  PubMed  Google Scholar 

  • Waldstein, S. R., Ryan, C. M., Manuck, S. B., Parkinson, D. K., & Bromet, E. J. (1991). Learning and memory function in men with untreated blood pressure elevation.Journal of Consulting and Clinical Psychology, 79 513–517.

    Google Scholar 

  • Wechsler, D. (1981).Manual for the Wechsler Adult Intelligence Scale—Revised. San Antonio, TX: The Psychological Corp.

    Google Scholar 

  • Wollam, G. L., & Hall, W. D. (1988). Mild hypertension: The effect of therapy on morbidity and mortality. In G. L. Wollam & W. D. Hall (Eds.),Hypertension Management (pp. 3–66). Chicago: Year Book Medical.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grossman, L.R., Zalewski, C. Hypertension and cognitive function. J Clin Psychol Med Settings 2, 233–248 (1995). https://doi.org/10.1007/BF01990879

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01990879

Key words

Navigation