Structured evaluation of unclear dyspnea-An attempt to shorten the diagnostic delay in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension

对不明原因呼吸困难进行结构化评估——旨在缩短肺动脉高压和慢性血栓栓塞性肺动脉高压的诊断延迟

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Abstract

BACKGROUND: Observational studies have reported cognitive domain alterations in individuals with Type 2 diabetes mellitus (T2D), affecting cognitive domains of information‐processing speed, memory, attention, and executive function. Epidemiological observational studies have shown an association between higher blood pressure [HBP], low processing speed, short‐term memory and learning, and delayed recall. Within the US Hispanic/Latino population, specifically Mexican Americans, cognition remains insufficiently studied. This preliminary analysis aims to discern the impact of T2D and hypertension on cognition, employing propensity score matching to mitigate confounders. METHOD: A dataset with 650 participants without dementia (mean age 50 ± 12.6 years, BMI 29.1 ± 6.6, 63% females) from the Mexican American Family Study Cohort from low economic strata was analyzed. The effects of T2D and HBP were evaluated using propensity score matching, specifically employing nearest‐neighbor matching under a logistic model. Coefficients (95% confidence intervals) and p‐values were reported. RESULT: Among the participants, 9% had T2D, 6% had HBP, and 2% had both conditions. Adjusting for sex, age, and BMI, the presence of T2D impacted face memory delay [b = 1.3 (0.1, 2.5) p = 0.032] and Continuous Performance Test (CPT) hits [b = 45.9 (24.7, 67.1) p<0.001]. Hypertension influenced California Verbal Learning Test (CVLT) learning [b = ‐11.1 (‐15.1, ‐7.4) p<0.001], CVLT recognition [b = ‐3.2 (‐6.1, ‐0.3) p = 0.03], and CPT hits [b = ‐31.1 (‐64.4, 2.3) p = 0.068)—Figure 1 CVLT score on T2D and HBP status. CONCLUSION: This preliminary study underscores the heightened risk of hypertension and T2D impacting cognitive function among Mexican Americans. Variations in cognitive measurements based on T2D or hypertension were observed, emphasizing the need for specific cognitive screening tools tailored to the prevalence of chronic conditions in this susceptible population.

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