Objective: Pulse pressure (PP), as a marker of large artery stiffness, is a risk factor for target organ damage in hypertension (HT). We hypothesized that elevated PP, as a marker of enhanced arterial stiffness, may be correlated with specific early target organ damage (TOD) of the brain - mild cognitive impairment (MCI).

Design and methods: 148 treated HT patients (Pts) - males 51 (34.5%), females 97 (65.5%) with mean age 64.16±11.18 years and mean hypertension history 13.1±11.05 years were included. Full medical history, esp. HT history, physical examination and laboratory screening were gathered. Only Pts in sinus rhythm were included. We screened the Pts for MCI with a battery of neuropsychological tests (NPTs): Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Ambulatory Blood Pressure Monitoring was conducted: mean day PP was 56.85±12.02 mmHg and mean night PP - 55.15±16.13 mmHg.

Results: Regression analysis found correlation between day and night PP and NPTs’ results. With Mann-Whitney Test (α<0.05) we found that there is a significant difference (sig. 0.023 for MMSE) in the mean values of the NPTs’ results between the groups with PP>50 and PP≤50 mmHg. Again with Mann-Whitney Test we assessed the significance of the difference between mean values of day-PP (sig. 0.01) and night-PP (sig. 0.02) between Pts with MCI and those without (resp.>55 and <55 mmHg).

Conclusion: Elevated PP in treated HT is a risk factor for MCI. We should screen Pts with HT for specific TOD - MCI.