Cognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos

Am J Hypertens. 2017 Jun 1;30(6):624-631. doi: 10.1093/ajh/hpx023.


Background: Hypertension control in Hispanics/Latinos lag behind general US trends by 10-15%. Intensive systolic blood pressure (SBP) management <120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP < 140 mm Hg) and more intensive (SBP < 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos.

Methods: From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45-74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English.

Results: Separate linear regressions revealed that being on 1 vs. >1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P < 0.01] and information processing speed [Beta = 3.01 (0.89), P < 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P < 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels <120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P < 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P < 0.05).

Conclusions: Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies.

Keywords: HCHS/SOL; Hispanics/Latinos.; antihypertensive treatment; blood pressure; blood pressure control; cognition; hypertension.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects*
  • Cognition*
  • Cross-Sectional Studies
  • Executive Function
  • Female
  • Health Knowledge, Attitudes, Practice / ethnology*
  • Hispanic or Latino / psychology*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / ethnology
  • Hypertension / physiopathology
  • Hypertension / psychology
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome
  • United States / epidemiology


  • Antihypertensive Agents