Department of Physiology, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India.
Department of Psychiatry, SDM College of Medical Sciences & Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India.
Curr Hypertens Rev. 2022;18(1):64-69. doi: 10.2174/1573402117666210511010824.
Acute stress is known to be associated with both negative and positive influences on cognitive performance. Hypertension is one of the risk factors for lowered cognitive performance. Mental stress testing is easier to administer and can be regulated by the investigator. Mental arithmetic using serial subtraction is the most widely used method to administer stress. Reaction time (RT) is widely used to assess cognitive domains like attention, execution and psychomotor speed. Researchers have shown choice reaction times are delayed in hypertension. It is not known whether acute mental stress improves or deteriorates attention, execution and psychomotor speed in hypertension. We hypothesized in the present study that acute mental stress deteriorates cognitive function in hypertensives without overt cerebrovascular disease or other vascular risk factors.
After getting medical ethical clearance from our institution, this case-control study was carried out over eight months (January 2017 to September 2017). 60 subjects between the age group of 35 to 55 years were included in the study. They were divided into 2 groups. Group 1 consisted of 30 diagnosed cases of hypertension at least two years of duration. Group 2 consisted of 30 sex and age-matched controls. MMSE was performed to assess the cognitive function in these groups. Simple (S) and choice (C) auditory reaction time (ART) and visual reaction time (VRT)s were measured at rest and acute mental stress in these groups to assess cognitive function. Predictive value of VRTC resting and VRTC during acute mental stress among hypertensives for cognitive dysfunction was calculated using the receiver operating characteristic (ROC) curve.
There was significant difference ART and VRT, both simple and choice, in hypertensive and nonhypertensive subjects and these reaction times further increased during mental stress (P<0.001). VRTC can be a predictor of cognitive dysfunction in hypertensives and during acute mental stress.
A significant difference in cognitive functions in hypertensive and nonhypertensive subjects exists and this further deteriorates with acute mental stress.
急性应激已知对认知表现既有负面影响，也有积极影响。高血压是认知表现下降的风险因素之一。心理应激测试更容易进行，并且可以由研究者进行调节。连续减法的心理算术是最常用的应激施加方法。反应时间（RT）广泛用于评估注意力、执行和心理运动速度等认知领域。研究人员已经表明，高血压患者的选择反应时间延迟。目前尚不清楚急性心理应激是否会改善或恶化高血压患者的注意力、执行和心理运动速度。我们假设在本研究中，急性心理应激会使无明显脑血管疾病或其他血管危险因素的高血压患者的认知功能恶化。
在获得我们机构的医学伦理批准后，这项病例对照研究在八个月（2017 年 1 月至 2017 年 9 月）内进行。研究纳入了 60 名年龄在 35 至 55 岁之间的受试者。他们被分为两组。第 1 组包括 30 名至少患有两年高血压的确诊病例。第 2 组包括 30 名性别和年龄匹配的对照者。对这些组进行简易精神状态检查（MMSE）以评估认知功能。在这些组中测量简单（S）和选择（C）听觉反应时间（ART）和视觉反应时间（VRT）在休息时和急性心理应激时的反应时间，以评估认知功能。使用受试者工作特征（ROC）曲线计算 VRTC 静息时和急性心理应激期间高血压患者认知功能障碍的预测值。
高血压和非高血压受试者的 ART 和 VRT，无论是简单还是选择，都有显著差异，这些反应时间在心理应激时进一步增加（P<0.001）。VRTC 可以预测高血压患者和急性心理应激期间的认知功能障碍。
高血压患者和非高血压患者的认知功能存在显著差异，并且随着急性心理应激而进一步恶化。
