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High blood pressure in dementia: How low can we go?

Yuda Turana1, Jeslyn Tengkawan1, Yook-Chin Chia2,3

  • 1Faculty of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.

Journal of Clinical Hypertension (Greenwich, Conn.)
|December 10, 2019
PubMed

Insights

High blood pressure (hypertension) is linked to cognitive decline. An optimal systolic blood pressure target of 120-130 mmHg is recommended for elderly patients, with personalized care being crucial.

Area of Science:

  • Gerontology
  • Cardiovascular Medicine
  • Neurology

Background:

  • Hypertension is a growing public health issue, increasingly linked to cognitive decline and dementia, particularly in aging Asian populations.
  • The rising prevalence of hypertension and age-related dementia in the oldest old group necessitates a review of current treatment strategies.
  • Understanding the complex relationship between blood pressure management and cognitive outcomes in the elderly is critical.

Purpose of the Study:

  • To discuss potential treatments for hypertension in the elderly.
  • To propose an optimal blood pressure target concerning cognitive outcomes.
  • To review controversial treatment strategies and the risks of overly aggressive or insufficient blood pressure management.

Main Methods:

  • A comprehensive review of longitudinal, cross-sectional, and randomized controlled trial (RCT) studies.
  • Analysis of existing research on blood pressure management in elderly populations.
  • Evaluation of the impact of specific antihypertensive medications on cognitive function.

Main Results:

  • An optimal systolic blood pressure target of 120-130 mmHg is suggested for non-diabetic hypertensive patients with significant risk factors.
  • Hypertension may confer a protective effect in the oldest old demographic.
  • Calcium channel blockers (CCB) and angiotensin receptor blockers (ARB) are associated with a reduced risk of dementia in older adults.

Conclusions:

  • Personalized treatment approaches are essential for managing hypertension in the elderly, especially for frail or very old individuals.
  • Careful consideration of blood pressure targets is needed to balance cardiovascular health and cognitive preservation.
  • Further research into tailored antihypertensive therapies, such as CCBs and ARBs, may help mitigate dementia risk in aging populations.

Keywords:
Asiacognitive dysfunctiondementiahypertensionoldest old

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