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Neurovascular and Cognitive Dysfunction in Hypertension

Costantino Iadecola1, Rebecca F Gottesman2,3

  • 1From the Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York (C.I.).

Circulation Research
|March 29, 2019
PubMed

Insights

Midlife hypertension is a risk factor for late-life dementia and may promote Alzheimer disease pathology. Further research is needed to understand the mechanisms and optimal treatment strategies for hypertension to prevent cognitive impairment.

Area of Science:

  • Neuroscience
  • Gerontology
  • Cardiology

Background:

  • Hypertension is a leading cause of age-related cognitive impairment.
  • It is linked to vascular dementia and Alzheimer disease.
  • The mechanisms by which hypertension affects cognition and Alzheimer disease are not fully understood.

Purpose of the Study:

  • To review recent advances in understanding the link between hypertension and cognitive decline.
  • To evaluate the evidence on whether hypertension treatment prevents cognitive impairment.
  • To identify outstanding questions and future research directions.

Main Methods:

  • Review of neurovascular biology, epidemiology, brain imaging, and biomarker studies.
  • Critical evaluation of existing evidence.
  • Synthesis of current knowledge and identification of research gaps.

Main Results:

  • Hypertension impacts cerebral blood vessel structure and function.
  • These cerebrovascular changes may contribute to cognitive impairment and Alzheimer disease pathology.
  • Advances in imaging and biomarkers offer new insights.

Conclusions:

  • Hypertension is a significant risk factor for dementia, including Alzheimer disease.
  • Understanding the mechanistic links is crucial for developing effective prevention and treatment strategies.
  • Further research is needed to determine optimal blood pressure thresholds and antihypertensive agents for cognitive health.

Keywords:
Alzheimer’s diseasebiomarkersbrain blood supplydementiarisk factorswhite matter pathology

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