3.4 Micro- and Macro-Vascular Remodeling and Cognitive Function in Hypertension

Cerebral microvascular alterations and hypoperfusion have been associated to cognitive disorder and dementia. We hypothesized that there is a direct link between retinal arteriolar remodelling, as assessed non-invasively using adaptive optics, and cognitive cerebral impairment in hypertensive patients. Hypertensive patients over 65 years old with or without mild cognitive impairment were recruited. Each patient had a cognitive evaluation with MMSE; a study of retinal vasculature with adaptative optics RTX1® Camera to measure WT, internal diameter (ID), wall-to-lumen ratio (WLR) and arterio-venous ratio (AVR); an aortic, cerebral and carotid MRI to study cerebral volumes and white matter hyper-intensities (WMH) and carotid/aortic backward/forward flow (BF/FF) and distensibility. Correlations between retinal and cerebral, carotid and aortic remodelling were analysed. 51 treated and controlled hypertensive patients, aged of 74 ± 5 years, 67