DETECT and Retinal Outcomes in Hypertension

Study Overview
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Brief Summary
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The purpose of this study is to study the impact of blood pressure on cognitive performance.

Detailed Description
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Four groups will be evaluated for possible impact of blood pressure on cognitive performance and retinal damage.

Official Title
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The Effects of Blood Pressure on Cognitive Function: Examining the Use of Bedside Neuropsychological Testing During Acute Hypertensive Events

Conditions
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Hypertension, Retinal Disorder, Cognitive Impairment

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients triaged to the Grady Memorial Hospital Emergency Department or Marcus Trauma Unit Age >18 and <65 Documented history of hypertension plus one or more of the following: current antihypertensive use with controlled blood pressure elevated Emergency Department systolic blood pressure or diastolic blood pressure OR - Acutely elevated Emergency Department systolic blood pressure or diastolic blood pressure on 2 separate Emergency Department measurements in the absence of a history of hypertension OR - Normal systolic blood pressure or diastolic blood pressure in the absence of hypertension. Exclusion Criteria: Non-English speaking Pre-visit cognitive impairment Physical or psychological impairments that would prohibit comprehension and completion of DETECT testing Inability to obtain adequate fundoscopic photos Acute intoxication, altered mental status, or head injury within the last 6 months Opiate or benzodiazepine administration by treating providers Clinical condition not allowing testing.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| controlled hypertension<br>hypertension with medication controlled | |
| uncontrolled hypertension<br>non-controlled hypertension | |
| hypertensive urgency<br>hypertensive urgency no previous history or antihypertensives | |
| asymptomatic normotensive<br>asymptomatic normotensive control group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| DETECT neurocognitive outcome scores (Z-scores) in association with blood pressure measures and retinal pathology (isolated retinal hemorrhage, grade III/IV hemorrhagic retinopathy) | We aim to determine the correlation (if any) between the severity of blood pressure and DETECT neurocognitive outcomes as well as the correlation (if any) between known Hypertensive retinal disease and DETECT neurocognitive outcomes. Appropriate statistical analysis will be performed to compare clinical retinal findings, BP values, and DETECT neurocognitive test outcomes. Subject level data will only be collected on the day of Emergency Department presentation. Subjects will not be followed after their initial enrollment. The study duration is projected for 12 months | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Variance of DETECT scores (Z-score) attributed to reading level |  | One year study periord (12 months) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Hypertension, Retinal Disorder, Cognitive impairment