Antihypertensive treatment can prevent stroke and cognitive decline

Area of Science:

• Neurology
• Cardiology
• Geriatrics

Background:

• Hypertension is a major risk factor for stroke and dementia, particularly small-vessel disease.
• Stroke, both lacunar and cortical, contributes to dementia, potentially via neuroinflammation.
• Despite improved control, undertreatment persists, especially in elderly patients due to concerns about adverse events.

Approach:

• This article reviews the link between hypertension, stroke, and dementia.
• It emphasizes the benefits of antihypertensive treatment in preventing brain diseases.
• It addresses physician reluctance to prescribe medication in older adults.

Key Points:

• Hypertension is the leading risk factor for small-vessel disease, lacunar infarction, and intracerebral hemorrhage.
• Ischemia-induced neuroinflammation likely mediates the relationship between stroke and dementia.
• Optimal blood pressure targets are essential for effective antihypertensive therapy.

Conclusions:

• Antihypertensive treatment offers a vital opportunity to prevent stroke and dementia.
• Physician hesitancy regarding antihypertensive medication in the elderly needs to be addressed.
• Managing hypertension is critical for brain health across all age groups.