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Treating Hypertension to Prevent Cognitive Decline and Dementia: Re-Opening the Debate

M Florencia Iulita1, Hélène Girouard2

  • 1Department of Neurosciences, Faculty of Medicine, Université de Montréal, 2900 Edouard-Montpetit, H3T 1J4, Montréal, QC, Canada.

Advances in Experimental Medicine and Biology
|October 21, 2016
PubMed

Insights

High blood pressure (hypertension) is a major risk factor for dementia, especially vascular dementia. While lowering blood pressure may prevent some dementia cases, its benefit for other types remains unclear.

Area of Science:

  • Gerontology
  • Neurology
  • Cardiovascular Medicine

Background:

  • Hypertension and dementia are leading age-related diseases.
  • Mid-life hypertension significantly increases late-life cognitive decline risk.
  • Hypertension is a primary risk factor for stroke and contributes to vascular and Alzheimer's dementia.

Purpose of the Study:

  • To review the relationship between hypertension and cognitive function.
  • To discuss evidence supporting and refuting antihypertensive medication for dementia prevention.

Main Methods:

  • Literature review of epidemiologic and mechanistic studies.
  • Analysis of evidence on blood pressure lowering and dementia risk.
  • Examination of antihypertensive medication's role in dementia prevention.

Main Results:

  • Strong evidence links hypertension to cognitive impairment.
  • Blood pressure reduction is effective in preventing post-stroke dementia.
  • The efficacy of antihypertensive drugs for preventing other dementia types is uncertain.

Conclusions:

  • Hypertension is a critical modifiable risk factor for dementia.
  • Further research is needed to clarify the role of antihypertensive medications in preventing non-vascular dementia.

Keywords:
Antihypertensive drugsCognitive dysfunctionDementiaHypertensionStrokeVascular risk factors

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