Cognitive Function as a Predictor of Incident Hypertension in Hispanic/Latino Adults: Results From the Community Health Study/Study of Latinos.

BACKGROUND: Studies showed that hypertension predicts cognitive performance. It remains uncertain whether a bidirectional relationship exists. We investigated whether cognitive function predicts incident hypertension. METHODS: Data from the Hispanic Community Health Study/Study of Latinos were analyzed. Global cognitive score (GC) of nonhypertensive participants at baseline was derived by averaging z scores across 4 neurocognitive tests (brief Spanish-English verbal learning test sum and recall, word fluency, and digit symbol substitution test). Incident hypertension was investigated, on average, 6 years later. Sociodemographic characteristics and unhealthy behaviors (obesity, physical activity not at goal, low diet quality, smoking) were ascertained at baseline. Association of GC at baseline with incident hypertension (defined as blood pressure ≥130/80 mm Hg or on treatment) was investigated using logistic regression analyses adjusted for sociodemographic characteristics and time between visits. Multimodal analyses assessed whether unhealthy behaviors were pathway variables between GC and incident hypertension. RESULTS: A total of 6755 participants (mean [interquartile range] age, 53[48-59] years; 62% female) were included. At follow-up, 57% of individuals developed hypertension. In our final model, higher GC was associated with lower odds of incident hypertension (odds ratio, 0.85 [95% CI, 0.74-0.98]). In pathway analysis, indirect effects through unhealthy behaviors were small. Obesity was the only significant mediator (indirect odds ratio, 0.95 [95% CI, 0.90-0.99]). Smoking and physical activity not at goal were in the pathway of GC and obesity, but did not mediate GC-incident hypertension. CONCLUSIONS: Higher GC was associated with a lower incidence of hypertension 6 years later. Unhealthy behaviors may influence the association of cognitive function and incident hypertension.