PREVALENCE OF COGNITIVE IMPAIRMENT IN A POPULATION WITH ATRIAL FIBRILLATION AND ITS RELATIONSHIP WITH ARTERIAL HYPERTENSION

Objective: 1. Document the prevalence of mild cognitive impairment (MCI) in hypertensive patients with atrial fibrillation (AF). 2. Assess the association between blood pressure control and MCI in patients with AF. Design and method: A descriptive, cross-sectional study was conducted from June 2023 to February 2024 on patients treated at the Cardiology Department of Hospital Maciel. Patients included were those with atrial fibrillation (AF) receiving warfarin treatment who met the following criteria: completion of at least one monthly INR check in the past six months, maintenance of an adequate therapeutic anticoagulation time range (TTR), and provision of informed consent. Exclusion criteria included illiteracy, severe psychiatric disorders, mechanical mitral valves, alcoholism, or a history of stroke Data were collected from medical records using a pre-packaged questionnaire. The Montreal Cognitive Assessment (MoCa) was used as a screening test for MCI. A score of 24 or lower was defined as “altered”, following a study by Spósito P., & Llorens M. (2022) in patients treated at the Maciel Hospital. The hypertension variable was measured as the average of five consecutive ambulatory blood pressure measurements (AMPA). The TTR was calculated using the Rosendaal method. Results: The final sample comprised 131 patients with a mean age of 74.1 years and a median education level of 6 years. MCI was identified in 65% (85 patients). When comparing patients with altered MoCA scores to those with normal scores (>24), the altered group had a median systolic blood pressure (SBP) of 130 mmHg (range 120–140 mmHg), a mean age of 75.8 years, and a median education level of 6 years. The normal group showed a median SBP of 120 mmHg (range 120–130 mmHg), a mean age of 72.3 years, and a median education level of 10 years. These differences were statistically significant, Regarding AF patterns, a statistically significant association was observed between the paroxysmal pattern and MOCA greater than 24. Conclusions: The high prevalence of MCI highlights the importance of early screening in this population. The MCI group had fewer years of schooling, older age and worse SBP control.