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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

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Effects of intensive blood pressure control on cognitive function in patients with cerebral small vessel disease

Bingqing Zhao1, Weihua Jia1, Ye Yuan1

  • 1Department of Neurology, Beijing Shijingshan Hospital, Shijingshan Teaching Hospital of Capital Medical University, China.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|August 6, 2023
PubMed

Insights

Intensive blood pressure control in elderly patients with cerebral small vessel disease (CSVD) can delay cognitive impairment. Lowering systolic blood pressure (SBP) to 126 mmHg reduced lacunar infarctions (LIs) and white matter hyperintensity (WMH) lesions.

Area of Science:

  • Neurology
  • Cardiology
  • Geriatrics

Background:

  • Cerebral small vessel disease (CSVD) is a common condition in elderly patients with hypertension.
  • Cognitive impairment is a frequent complication of CSVD.
  • Effective management strategies for CSVD and associated cognitive decline are needed.

Purpose of the Study:

  • To investigate the impact of intensive blood pressure control on cognitive function in elderly patients with CSVD.
  • To evaluate the effect of intensive blood pressure management on neuroimaging markers of CSVD.

Main Methods:

  • 140 elderly patients with CSVD and hypertension were randomized into standard and intensive blood pressure control groups.
  • Patients were followed for 2 years with adjusted antihypertensive medication dosages.
  • Cognitive function was assessed using MMSE and MoCA; neuroimaging evaluated lacunar infarctions (LIs) and white matter hyperintensity (WMH).

Main Results:

  • The intensive group showed better cognitive scores (MMSE, MoCA) compared to the standard group after 2 years.
  • Intensive blood pressure control significantly reduced WMH and LIs.
  • Systolic blood pressure (SBP) and diastolic blood pressure (DBP) reductions were independently correlated with improved MMSE scores.

Conclusions:

  • Lowering SBP to 126 mmHg, compared to 134 mmHg, delays cognitive impairment in elderly hypertensive patients with CSVD.
  • Intensive blood pressure control effectively reduces LIs and cerebral WMH lesions.
  • This strategy offers a promising approach to managing cognitive decline in CSVD patients.
Abstract

Keywords:
CSVDCognitive functionElderlyHypertensionIntensive blood pressure reduction

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