Determinants of Cognitive Performance Among Ghanaian Hypertensive Patients: A Cross-Sectional Study

Abstract

Background

Cognitive decline is one of the most deleterious consequences of hypertension. Hypertension is rife in sub-Saharan Africa, where control of blood pressure is abysmally poor.

Objective

This study is aimed at assessing the determinants of cognitive performance among Ghanaian hypertensive patients.

Methods

This was a cross-sectional study conducted at a single district hospital among hypertensives aged ≥ 18 years. Global cognitive performance is assessed using the Montreal Cognitive Assessment (MOCA). A multivariable linear regression analysis was performed, and a beta coefficient was computed to identify factors independently associated with the MOCA score.

Results

We enrolled 214 adults living with hypertension; the mean (SD) age was 64 (13.4) years, and 168 (78.5%) were females. Factors, with their adjusted beta coefficients (95% CI), independently associated with cognitive performance were age, −0.10 (−0.16, −0.04), p < 0.001; female sex, −2.3 (−4.2, −0.35), p = 0.021, secondary and tertiary-level educational attainment +5.2 (3.5, 6.9), p < 0.001 and +4.1 (0.49, 7.7), p = 0.026 respectively. In sensitivity unadjusted analyses, body mass index (BMI), with a beta coefficient of +0.18(0.08, 0.29), p < 0.001, was associated with MOCA score in females. Among the male participants, a history of heart failure, −11 (−15, −5.9), p < 0.001, history of stroke −11 (−15, −5.9), p < 0.001, BMI −0.31 (−0.49, −0.13), p = 0.002 and uncontrolled hypertension −3.5 (−6.9, −0.15), p = 0.047 were associated with MOCA score.

Conclusion

Increasing age and female sex are associated with poorer global cognitive performance, while higher educational attainment is associated with good global cognitive performance among Ghanaians living with hypertension.