International Journal of Hypertension / 2012 / Article / Tab 1

Review Article

From Brain to Behavior: Hypertension's Modulation of Cognition and Affect

Table 1

Diagrammatic illustration of integrated study of the natural history of hypertension.

Stage of DiseasePhysiologyAffectiveCognitive

Normotensive/youth (genetic/familial risk)All normal possible hyper-reactivity to lab stress, Mild elevation in SBP Opioid dysregulationAnger? Reduced pain sensitivitySubtle spatial attention, short term memory deficit
Borderline/Pre-hypertensiveBP >119/79 <140/90 with predominance of elevated DBP, sympathetic activation High cardiac output Baroreceptor adjustment; hyper reactivity to lab stressInterpersonal difficulty Pain insensitivity Less awareness negative affect, positive affect?
Early Hypertension
BP >140/90 High TPR Salt/diet sensitive Renin/angiotensin Aldosterone Sympathetic Structural/function brain changes HyperreactivityAbove with transition to greater negative affect with inhibition of the expression of intense angry cognitive and emotive reactionsMild deficits executive attention, working memory
Late Hypertension
(60+ yrs)
Same BP or isolated systolic hypertension? maintenance of altered regulatory systemContinued high negative affect and expression of negative affect?; awareness of BP status may invert relationshipDeficits not as clear relative to age matched; Related to Alzheimer’s Disease

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