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Updated: Jul 16, 2025

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Basic Mechanisms of Brain Injury and Cognitive Decline in Hypertension

Caroline E Baggeroer1, Francis E Cambronero1, N Anna Savan2

  • 1Vanderbilt Memory and Alzheimer's Center (C.E.B., F.E.C., A.L.J., M.M.S.), Vanderbilt University Medical Center, Nashville, TN.

Hypertension (Dallas, Tex. : 1979)
|September 21, 2023
PubMed

Insights

High blood pressure (hypertension) significantly increases dementia risk. Understanding how hypertension damages brain blood vessels is key to developing new treatments for cognitive decline.

Area of Science:

  • Neuroscience
  • Cardiovascular Science
  • Gerontology

Background:

  • Dementia affects nearly 50 million adults globally, representing a major cause of death and disability.
  • Hypertension is a primary risk factor for dementia, including Alzheimer disease and related dementias.
  • The precise mechanisms linking hypertension to cognitive decline are not fully understood.

Purpose of the Study:

  • To review the basic mechanisms of cerebrovascular adaptations to elevated blood pressure.
  • To explore hypertension-induced microvascular injury in the brain.
  • To assess cellular mechanisms of neurovascular unit dysfunction and its role in cognitive impairment.

Main Methods:

  • Review of existing literature on hypertension and brain health.
  • Analysis of cellular and molecular mechanisms of neurovascular dysfunction.
  • Summary of cognitive deficits observed in rodent models of hypertension.

Main Results:

  • Hypertension leads to detrimental cerebrovascular changes and microvascular injury.
  • Neurovascular uncoupling, where neuronal metabolic demands are unmet, contributes to cognitive impairment.
  • Rodent models exhibit various cognitive deficits associated with hypertension.

Conclusions:

  • Despite advances in antihypertensive therapies, hypertension remains a critical factor in cognitive decline.
  • Further research is needed to fully understand the development and progression of hypertension-induced cognitive impairment.
  • Identifying mechanisms of hypertension's effects on the brain can inform therapeutic strategies for brain protection.

Keywords:
cerebral small vessel diseasecognitive declinedementiahypertensionneurovascular unit

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