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Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

Yang Liu1, Yan-Hong Dong2, Pei-Yuan Lyu1

  • 1Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017; Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China.

Chinese Medical Journal
|February 28, 2018
PubMed

Insights

Hypertension causes changes in cerebral small vessel disease (CSVD), leading to cognitive impairment. Managing blood pressure is crucial for preventing cognitive decline associated with CSVD.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Gerontology

Background:

  • Alzheimer's disease and vascular dementia account for over 80% of dementia cases.
  • Hypertension is a shared risk factor for both Alzheimer's disease and vascular dementia.
  • Cerebral small vessel disease (CSVD) is strongly linked to hypertension and cognitive impairment.

Purpose of the Study:

  • To review pathophysiological changes in CSVD caused by hypertension.
  • To explore the relationship between CSVD and cognitive impairment.

Main Methods:

  • PubMed database search for literature up to December 2017.
  • Keywords included hypertension, CSVD, white matter lesions, enlarged perivascular spaces, lacunar infarcts, cerebral microbleeds, and cognitive impairment.
  • Analysis of hypertension-induced CSVD changes and their correlation with cognitive impairment.

Main Results:

  • Hypertension leads to progressive changes in cerebral small vessels, including lesions, inflammation, and blood-brain barrier damage.
  • Poor blood pressure control exacerbates CSVD, contributing to cognitive decline.
  • Both isolated and co-occurring CSVD impact cognitive function through cholinergic system or tract dysfunction.

Conclusions:

  • Hypertensive vasculopathy and inflammation in CSVD are key indicators of cognitive impairment development.
  • Further research is needed to validate the link between blood pressure levels, CSVD progression, and cognitive status.
  • Investigating the impact of CSVD characteristics (number, volume, location) on cognitive impairment is essential.
Abstract

Keywords:
Cerebral MicrobleedsCerebral Small Vessel DiseaseCognitive ImpairmentHypertension

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