Arterial hypertension and high blood pressure (BP) are major risk factors for cardiovascular disease (CVD) and stroke; they are also risk factors for lowered cognitive functioning. Except for diabetes, there have been comparatively few studies of other common risk factors, particularly with regard to interrelationships among risk factors which may adversely affect cognitive ability. This study is concerned with associations between cognitive functioning and three major CVD risk factors: (1) BP, (2) high total plasma homocysteine (tHcy), and (3) ApoE e4 genotype. Although high BP is a well-established risk factor for lowered cognitive functioning, tHcy and ApoE e4 are relatively unexplored variables with respect to cognitive functioning. A major objective is to investigate the individual, cumulative, and synergistic effects of BP, tHcy levels, and ApoE e4 genotype on cognitive functioning over a broad range of cognitive abilities. Three secondary, but important, objectives are to determine: (1) the extent to which the adverse influence of these three CYD risk factors on cognitive functioning is affected by the presence of coexisting CVD risk factors (e.g., cigarette smoking); (2) the cumulative impact of multiple risk factors on cognitive functioning; (3) the extent to which age effects on cognitive functioning are attenuated by adjustment for BP, tHey, ApoE genotype, and other CVD risk factors. The study makes use of existing data from a large longitudinal study of hypertension and cognitive functioning. Additionally, important new information about relations among tHey, ApoE, and BP will be obtained by calling back the longitudinal subjects for additional studies of cognitive functioning and making use of concurrent, prospective, and retrospective analyses.
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