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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Impact of Hypertension on Cognitive Decline and Dementia

Han Lin Naing1, Shyh Poh Teo2

  • 1Department of Neurology, Brunei Neuroscience Stroke & Rehabilitation Centre, Jerudong, Brunei Darussalam.

Annals of Geriatric Medicine and Research
|August 4, 2020
PubMed

Insights

Treating hypertension in middle-aged and older adults may reduce dementia incidence. The Systolic Hypertension in Europe trial showed calcium-channel blockers significantly lowered dementia risk.

Area of Science:

  • Neurology
  • Gerontology
  • Cardiology

Background:

  • Dementia significantly impairs daily living and is a leading global cause of morbidity.
  • Preventive measures for dementia are largely ineffective.
  • Hypertension is linked to vascular dementia and may influence Alzheimer disease pathology.

Purpose of the Study:

  • To review randomized controlled trials on antihypertensive treatments and their impact on cognitive decline.
  • To assess the potential of hypertension management in reducing dementia incidence.

Main Methods:

  • Review of randomized controlled studies investigating antihypertensive effects on cognition.
  • Analysis of observational data linking hypertension to brain changes and cognitive decline.
  • Examination of cohort studies on hypertension treatment duration and cognitive decline.

Main Results:

  • Observational studies indicate hypertension is associated with white matter lesions, hippocampal atrophy, and cognitive decline.
  • Both elevated and reduced blood pressure levels correlate with white matter lesion development.
  • The Systolic Hypertension in Europe (Syst-EUR) trial, using calcium-channel blockers, was the only study to show a significant decrease in dementia incidence.

Conclusions:

  • Active hypertension treatment in middle-aged and older adults may be a viable strategy to reduce dementia incidence.
  • Current evidence from randomized trials is limited, with only one trial demonstrating a significant benefit.
  • Further research is necessary to confirm the long-term efficacy of antihypertensive therapies in preventing dementia.

Keywords:
Alzheimer diseaseDementiaHypertensionPreventionWhite matter

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