Cerebral Microbleeds Are Associated With Mild Cognitive Impairment in Patients With Hypertension

BACKGROUND: Cerebral microbleeds (CMBs) are hypothesized downstream markers of brain damage caused by vascular and amyloid pathologic mechanisms. The aim of this study was to determine whether CMB count and location are associated with an increased risk for mild cognitive impairment (MCI) in patients with essential hypertension without a history of transient ischemic attack or stroke. METHODS AND RESULTS: In this cross‐sectional study, patients were prospectively enrolled from consecutive outpatients with essential hypertension 50 years and older at 3 centers in northern China. Generalized linear Poisson models were used to determine the association between the number and location of CMBs and MCI in patients with hypertension. The association of microbleeds with different cognitive domains was estimated using linear mixed models. The presence, number, and distribution of CMBs were greater in patients with hypertension who had MCI (P<0.001). The presence of any CMBs, strictly lobar CMBs, and deep or infratentorial CMBs were all related to MCI after adjusting for age, sex, education, cardiovascular risk factors, body mass index, intima‐media thickness, the presence of silent lacunar infarctions, white matter lesion grade, and brain atrophy. Furthermore, the presence of multiple microbleeds (≥5) was associated with lower Montreal Cognitive Assessment total scores and worse performance on specific domains of cognitive tests, such as global cognitive function, information processing speed, and motor speed. CONCLUSIONS: This study suggests that the presence of and a greater number of cerebral CMBs independently correlate with MCI in patients with essential hypertension without a history of transient ischemic attack or stroke.