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[Arterial hypertension and cognitive decline]
1Service de neurologie et pathologie neurovasculaire, Hôpital Roger Salengro. dleys@chru-lille.fr
Insights
Arterial hypertension, or high blood pressure, is linked to cognitive decline and dementia. Managing blood pressure may help reduce dementia risk, though more research is needed.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Geriatrics
Context:
- Arterial hypertension is a primary risk factor for stroke.
- The link between hypertension and cognitive decline/dementia is complex.
- Hypertension is an independent risk factor for cognitive impairment.
Purpose:
- To explore the intricate relationship between arterial hypertension and cognitive decline.
- To investigate the impact of hypertension on cognitive functions and white matter changes.
- To assess the potential of hypertension treatments in mitigating dementia risk.
Summary:
- Cognitive functions are impaired in hypertensive patients, particularly with lower education, higher age, and severe hypertension.
- Hypertension contributes to cognitive decline through white matter changes.
- Elevated blood pressure at age 70 correlates with increased dementia risk years later.
Impact:
- Hypertension management may play a crucial role in preventing cognitive decline and dementia.
- Further clinical trials are essential to confirm the neuroprotective effects of hypertension treatments.
- Findings highlight the importance of addressing hypertension for brain health in aging populations.
Abstract:
Arterial hypertension is the leading risk factor for all stroke subtypes. However, its relationship with cognitive decline and dementia is more complex than a simple causal relationship. Cognitive functions are worse in patients with arterial hypertension, especially when the level of education is lower, age higher and arterial hypertension more severe. Arterial hypertension is an independent factor of cognitive decline. It also leads to white matter changes which contribute to the cognitive decline. Longitudinal studies have shown that a higher blood pressure at the age of 70 years is associated with an increased risk of dementia (vascular or Alzheimer) 10 to 15 years later, but blood pressure spontaneously decreases as dementia occurs. Treatments of arterial hypertension decrease the incidence of stroke, but clinical trials are still necessary to determine if they also decrease the incidence of dementia. Preliminary results obtained in elderly subjects with systolic arterial hypertension, support this hypothesis.