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Hypertension and risk of post-operative cognitive dysfunction (POCD): a systematic review and meta-analysis

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Item Type:Review
Title:Hypertension and risk of post-operative cognitive dysfunction (POCD): a systematic review and meta-analysis
Creators Name:Feinkohl, I., Winterer, G. and Pischon, T.
Abstract:BACKGROUND: Post-operative cognitive dysfunction (POCD) occurs frequently after major surgery. Hypertension is well-established as a risk factor for age-related cognitive impairment, but it is unclear whether or not it also increases the risk of POCD. OBJECTIVE: To evaluate the role of hypertension in POCD risk in a systematic review and meta-analysis. METHOD: PubMed, Ovid SP and the Cochrane Database of Systematic Reviews were searched for longitudinal studies of adults undergoing surgery with reporting of hypertension, blood pressure and/or anti-hypertensive treatment associations with POCD as relative risks or odds ratios. Fixed-effects meta-analyses were performed using Review Manager (version 5.3). RESULTS: Twenty-four studies on 4317 patients (mean age 63 years) were included. None of the studies had set out to assess hypertension as a risk factor for POCD. Hypertension was used as a categorical predictor throughout and only 2 studies adjusted for potential confounders. Across all 24 studies, hypertension was not significantly associated with POCD risk (RR 1.01; 95% CI 0.93, 1.09; p=0.82), though among 8 studies with >75% males, we found hypertension associations with a 27% increased risk of POCD (RR 1.27, 95% CI 1.07, 1.49; p=0.005). CONCLUSION: Our findings do not support the hypothesis that hypertension is a risk factor for POCD. However, since none of the studies included in our analysis were hypothesis-driven and most did not adjust for potential confounders, further systematic investigations are needed to evaluate the role of hypertension in the epidemiology of POCD.
Keywords:Cognitive Epidemiology, Blood Pressure, Hypertension, Post-Operative Cognitive Dysfunction, POCD, Meta-Analysis
Source:Clinical Practice and Epidemiology in Mental Health
ISSN:1745-0179
Publisher:BioMed Central
Volume:13
Page Range:27-42
Date:18 May 2017
Official Publication:https://doi.org/10.2174/1745017901713010027
PubMed:View item in PubMed

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