Life (Basel, Switzerland) · 2026
Arterial Stiffness and Anti-NR2/GluN2 Autoantibodies to N-Methyl-D-Aspartate Receptors as Markers of Vascular Aging and Cognitive Impairment in Arterial Hypertension.
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Safronova Tatiana, Mukhanova Sofia, Bragina Anna, Tarzimanova Aida, Ivannikov Alexander, Vargina Tatiana, Pokrovskaya Anna, Rodionova Julia, Druzhinina Natalia, Vasilyeva Lyubov, Cherepanov Alexander, Dorokhov Nikolay, Gureva Natalia, Dragomiretskaya Natalia A, Loriya Irakli Zh, Podzolkov Valery
Аннотация
BACKGROUND: Arterial hypertension (HTN) is associated with accelerated vascular aging, cerebral microvascular injury, and cognitive decline. Anti-NR2/GluN2 (NR2) antibodies may be related to N-methyl-D-aspartate receptor (NMDAR)-mediated neuronal-ischemic injury, although their clinical significance in HTN requires further clarification.
OBJECTIVE: The aim of this study was to evaluate cross-sectional associations between arterial stiffness assessed by the cardio-ankle vascular index (CAVI), serum NR2 antibody levels, and cognitive performance assessed by the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with essential HTN and controls.
METHODS: This single-center study included 175 adults aged 40-70 years: 128 patients with essential HTN and 47 controls. The median age was 58 [54; 66] years in the HTN group and 55 [47; 62] years in controls (p = 0.06). Men accounted for 52 patients (40.6%) in the HTN group and 14 participants (30.0%) in the control group (p = 0.22). Arterial stiffness was assessed using CAVI. Serum NR2 antibody levels were measured by enzyme-linked immunosorbent assay. Cognitive status was evaluated using MoCA and MMSE. Between-group comparisons, correlation analysis, and exploratory classification modeling were performed.
RESULTS: Patients with HTN had higher CAVI values than controls (8.3 [7.3; 9.4] vs. 7.3 [6.9; 7.9]; p = 0.001). Cognitive impairment was more frequent in hypertensive patients by both MoCA (52.3% vs. 27.7%; p = 0.003) and MMSE (48.7% vs. 28.3%; p = 0.01). NR2 antibody levels were higher in HTN (1.6 [1.15; 2.62] vs. 1.33 [1.02; 1.84] ng/mL; p = 0.03). CAVI inversely correlated with MoCA and MMSE scores.
CONCLUSIONS: CAVI was higher in patients with HTN and showed modest inverse associations with cognitive scores. NR2 antibody levels were also higher in HTN; however, their relationship with cognitive impairment should be interpreted as exploratory and hypothesis-generating. Further longitudinal studies with neuroimaging are required to determine the clinical and prognostic significance of these findings.
OBJECTIVE: The aim of this study was to evaluate cross-sectional associations between arterial stiffness assessed by the cardio-ankle vascular index (CAVI), serum NR2 antibody levels, and cognitive performance assessed by the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) in patients with essential HTN and controls.
METHODS: This single-center study included 175 adults aged 40-70 years: 128 patients with essential HTN and 47 controls. The median age was 58 [54; 66] years in the HTN group and 55 [47; 62] years in controls (p = 0.06). Men accounted for 52 patients (40.6%) in the HTN group and 14 participants (30.0%) in the control group (p = 0.22). Arterial stiffness was assessed using CAVI. Serum NR2 antibody levels were measured by enzyme-linked immunosorbent assay. Cognitive status was evaluated using MoCA and MMSE. Between-group comparisons, correlation analysis, and exploratory classification modeling were performed.
RESULTS: Patients with HTN had higher CAVI values than controls (8.3 [7.3; 9.4] vs. 7.3 [6.9; 7.9]; p = 0.001). Cognitive impairment was more frequent in hypertensive patients by both MoCA (52.3% vs. 27.7%; p = 0.003) and MMSE (48.7% vs. 28.3%; p = 0.01). NR2 antibody levels were higher in HTN (1.6 [1.15; 2.62] vs. 1.33 [1.02; 1.84] ng/mL; p = 0.03). CAVI inversely correlated with MoCA and MMSE scores.
CONCLUSIONS: CAVI was higher in patients with HTN and showed modest inverse associations with cognitive scores. NR2 antibody levels were also higher in HTN; however, their relationship with cognitive impairment should be interpreted as exploratory and hypothesis-generating. Further longitudinal studies with neuroimaging are required to determine the clinical and prognostic significance of these findings.