Behavioral consequences of mild hypertension.

Tests made of the sensory-perceptual, cognitive, and psychomotor abilities of untreated young patients with essential hypertension have revealed a pattern suggesting a slight functional impairment of the central nervous system. Reduced performance was most marked for those tasks requiring speed and psychomotor coordination, particularly when the behaviors observed were self-initiated. Lowered scores were more evident among female hypertensives; no differences in performance by race were noted. The deficits measured by these sensitive tests do not appear to be great enough to intrude on everyday activity nor to impair work ability. Changes that may result from blood-pressure-lowering therapies will require further study.

Test-taking behaviors by hypertensive and normotensive individuals.

Systematic ratings were made on the Tulane Test-Behavior Scale of the global and integrated behaviors observable for hypertensive and normotensive subjects as they worked to complete a battery of neuropsychological tests--the degree of attention and effort displayed, for example, self-confidence and self-criticism. The results for 82 subjects (41 subject pairs matched for age, race, and education) revealed substantial and consistent differences between groups. Early, mild hypertensive subjects (unmedicated) displayed significantly less optimal behaviors than did normotensive controls. These may be best understood as subtle functional consequences of the abnormal physiological state imposed on the brain by a chronically elevated blood pressure, just as the functional disruptions of reduced kidney filtration fraction or minor abnormalities of the electrocardiogram appear early in the course of the disorder for other target organs. Certain testable implications of this hypothesis are discussed.