International Journal of Obesity (2003) 27, 260–268. doi:10.1038/sj.ijo.802225

Lower cognitive function in the presence of obesity and hypertension: the Framingham heart study

M F Elias1,2, P K Elias1, L M Sullivan3, P A Wolf4 and R B D'Agostino1

  1. 1Department of Mathematics and Statistics, Statistics and Consulting Unit, Boston University, Boston, MA, USA
  2. 2Department of Psychology, University of Maine, Orono, ME, USA
  3. 3Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
  4. 4Department of Neurology, Boston University School of Medicine, Boston, MA, USA

Correspondence: Dr MF Elias, Department of Mathematics and Statistics, Statistics and Consulting Unit, Boston University, 111 Cummington St., Boston University, Boston, MA 02215, USA. E-mail:

Received 21 April 2002; Revised 7 August 2002; Accepted 7 October 2002.



OBJECTIVE: To determine the independent effects of obesity and hypertension on cognitive functioning.

METHODS: Using a prospective design, male (n=551) and female (n=872) participants of the Framingham Heart Study were classified by presence or absence of obesity and hypertension based on data collected over an 18-y surveillance period. All subjects were free from dementia, stroke, and clinically diagnosed cardiovascular disease up to the time of cognitive testing. Statistical models were adjusted for age, education, occupation, cigarette smoking, alcohol consumption, total cholesterol, and a diagnosis of type II diabetes. Body mass index status (nonobese or obese) and blood pressure status (normotensive or hypertensive) were then related to cognitive performance (learning, memory, executive functioning, and abstract reasoning) on tests administered 4–6 y later.

RESULTS: Adverse effects of obesity and hypertension on cognitive performance were observed for men only. Obese and hypertensive men performed more poorly than men classified as either obese or hypertensive, and the best performance was observed in nonobese, normotensive men.

CONCLUSIONS: The adverse effects of obesity and hypertension in men are independent and cumulative with respect to cognitive deficit.


obesity, hypertension, men, women, cognitive functioning

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