Abstract Body (Do not enter title and authors here): Background :
Hypertension is a key contributor to cognitive decline, significantly impacting global neurological health. Using Global Burden of Disease (GBD) 2019 data, we quantified hypertension’s contribution to cognitive impairment, identified vulnerable populations, and highlighted modifiable risk factors to inform American Heart Association (AHA) prevention strategies.

Research Question:
What is the global burden of cognitive impairment attributable to hypertension, including its contribution to disability-adjusted life years (DALYs), associated risk factors, vulnerable populations, and temporal trends from 2010 to 2019, as analyzed using GBD 2019 data?

Methods:
We analyzed data from the GBD 2019 study for disability-adjusted life years (DALYs) due to cognitive impairment (ICD-10 codes F00–F03, G30) attributable to hypertension. Age- standardized DALY rates were stratified by sex, age (50–74 and ≥75 years), and global region. Co occurring risk factors including obesity and smoking were assessed via GBD’s comparative risk assessment framework. Hypertension treatment coverage was estimated using Noncommunicable Disease Risk Factor Collaboration (NCD-RisC) data. Temporal trends from 2010 to 2019 were analyzed using annual percent change (APC).

Results:
Hypertension contributed to 12.3 million DALYs globally in 2019, representing 18.7% of the total cognitive impairment burden (age-standardized DALY rate: 160.4 per 100,000). Individuals aged ≥75 years accounted for 70% of these DALYs. Women experienced 13% higher burden than men (170.2 vs. 150.6 per 100,000). Low-income regions had higher DALY rates (180.5 per 100,000) compared to high income regions (140.2 per 100,000). Uncontrolled hypertension was associated with an odds ratio of 2.4 (95% CI: 2.0–2.9) for cognitive impairment, with obesity (adjusted OR 2.8) and smoking (adjusted OR 1.7, 95% CI: 1.4–2.0) amplifying the risk. From 2010 to 2019, global DALYs increased by 1.5% annually, with the fastest rise in East Asia (+2.1% APC).

Conclusions:
Hypertension is a major, modifiable driver of global cognitive impairment, with significant sex and regional disparities. Implementation of AHA aligned strategies such as intensified blood pressure control and targeted cognitive screening in adults aged ≥60 is critical to reducing this preventable burden.