Association between myocardium hypertrophy and dementia: a study of autopsy of population basis

• Grant number: 23/14807-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2024
• End date: December 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Regina Silva Paradela
• Grantee: Heberti Eliakim Silva
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Introduction: Dementia is a cognitive disorder that interferes with daily functioning and results in loss of independence. The projection for 2050 is that there will be 153 million people living with dementia around the world, and most of these people will live in low- to middle-income countries, where the prevalence of risk factors for dementia is higher.. Hypertension is one of the main modifiable risk factors for dementia. One way to assess uncontrolled high blood pressure is through left ventricular hypertrophy, as hypertension generates pressure overload and causes hypertrophy - more commonly on the left ventricle. Previous imaging studies have already shown the relationship between left ventricular hypertrophy (LVH) and cognitive impairment. Despite that, no previous study has evaluated the association between LVH and cognition using direct measurements obtained through autopsy. Furthermore, little is known about this relationship in diverse populations in low and middle-income countries like Brazil. Thus, this study aims to evaluate the association between LVH, as a marker of long term untreated arterial hypertension, and cognitive abilities, assessed by the Clinical Dementia Rating Scale (CDR). Methods: We will use data from the Biobank for Aging Studies from the College of Medicine of the University of São Paulo (FMUSP). The diagnosis of hypertension was obtained through a structured interview with an informant close to the deceased. The LVH was defined based on anatomical analysis and the left ventricular free wall measurement. The free wall of the left ventricle was measured with a ruler, one centimeter below the aortic valve, on the wall diametrically opposite to the interventricular septum. The assessment of cognitive performance and dementia was realized in the structured interview using the Clinical Dementia Rating scale (CDR). Keywords: cognitive impairment, dementia, hypertension, left ventricular hypertrophy.