Cognitive impairment is a major public health challenge, particularly among aging populations with hypertension. The study by Zuo and Yang provides valuable insights into the predictive risk factors for cognitive decline in hypertensive patients, utilizing a model with strong discriminative ability (AUC ROC: 0.802 in training set, 0.756 in test set). This letter highlights seven key risk factors identified in the study: gender, age, education level, poverty income ratio (PIR), depression, vigorous physical activity, and creatinine levels. Men exhibited a higher risk of cognitive impairment than women, likely due to estrogen's neuroprotective effects. Advancing age and lower education levels were also strong predictors of cognitive decline. Additionally, socioeconomic disparities and depression significantly influenced cognitive health, underscoring the need for integrated mental health and policy interventions. Protective factors, such as vigorous physical activity and lower creatinine levels, emphasize the importance of lifestyle-based strategies. Implementing this predictive model in routine clinical assessments can aid in early detection and personalized intervention. Future research should refine these findings, incorporating genetic predisposition and dietary influences to enhance cognitive health management in hypertensive patients.