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Hypertension and the Risk of Dementia

Cristina Sierra1

  • 1Hypertension & Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona (IDIBAPS), University of Barcelona, Barcelona, Spain.

Frontiers in Cardiovascular Medicine
|February 22, 2020
PubMed

Insights

Midlife hypertension increases dementia risk, but the link between blood pressure and cognitive function in older adults remains unclear. Optimal blood pressure targets for cognitive health are unknown.

Area of Science:

  • Neurology
  • Cardiovascular Science
  • Gerontology

Background:

  • Midlife hypertension is linked to increased risk of cognitive decline and dementia, including Alzheimer's disease.
  • Cerebral small vessel disease is a key factor in this association.
  • Observational studies suggest antihypertensive treatment may benefit cognition, but randomized trials yield conflicting results.

Purpose of the Study:

  • To explore the complex relationship between hypertension, blood pressure management, and cognitive function.
  • To investigate the role of cerebral small vessel disease in hypertension-related cognitive decline.
  • To clarify the optimal blood pressure targets for preserving cognitive function, particularly in the elderly.

Main Methods:

  • Review of observational studies on hypertension and cognitive decline.
  • Analysis of randomized clinical trials (RCTs) on antihypertensive treatment and cognitive outcomes.
  • Examination of studies investigating blood pressure and cognitive function in the very elderly and frail.

Main Results:

  • Observational data suggest a potential benefit of antihypertensive treatment for cognitive decline.
  • RCTs have provided inconclusive evidence regarding the efficacy of antihypertensive treatment in preventing cognitive decline.
  • Some studies indicate a correlation between low blood pressure and poorer cognitive function in very elderly or frail individuals.

Conclusions:

  • The precise relationship between hypertension, blood pressure management, and cognitive function, especially in older adults, requires further investigation.
  • Optimal blood pressure levels for cognitive protection in the elderly are not yet established.
  • Cerebral small vessel disease plays a significant role in the pathophysiology linking hypertension to cognitive impairment.

Keywords:
antihypertensive treatmentcognitive functioncognitive impairmentdementiaessential hypertensionhigh blood pressure

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