Effects of stage I hypertension on the recovery of early postoperative attention network function in elderly patients undergoing elective hip or knee arthroplasty surgery

BACKGROUND/AIM: Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension (HPs) and normotensive patients (NPs) showed differences in the recovery of postoperative attention network function according to the attentional network test (ANT) performance. MATERIALS AND METHODS: Of 110 patients screened, 25 HPs and 25 NPs completed this study. The Mini-Mental State Examination (MMSE) was applied to all participants before the operation and the ANT (on days 2 and 7) after the operation. All participants completed 1 day preoperatively and the ANT on postoperative days (PODs) 2 and 7. RESULTS: Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD 7. However, no significant difference was observed between the groups on POD 2. Orienting network performance was similar between the groups at all time points. Significant differences in alerting and executive control network performances were observed between PODs 2 and 7 in each group. CONCLUSION: HPs showed selective cognitive impairment at different time points following elective hip or knee arthroplasty. Compared with NPs, during the first postoperative week, HPs were more likely to experience delayed recovery of alerting and executive control network function, but not orienting network function.