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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
Summary
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.
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