Cognitive impairment and the threat of dementia pandemic or the journey of hypertensive patients to self-care deficit

Česká verzia

Authors: Peter Wohlfahrt
Authors place of work: Pracoviště preventivní kardiologie, IKEM, Praha
Published in the journal: Vnitř Lék 2022; 68(8): 532-536
Category: Review Articles
doi: https://doi.org/10.36290/vnl.2022.112

Summary

In the Czech Republic, due to the population aging, the prevalence of cognitive dysfunction is increasing. Researchers estimate that by 2050 the number of patients with dementia in the Czech Republic will more than double. Since dementia cannot be cured, it is important to prevent the cognitive dysfunction development by influencing modifiable risk factors. Arterial hypertension (AH) is one of the main risk factors for the development of cognitive dysfunction and dementia. Elevated blood pressure values in youth are associated with a higher risk of cognitive decline in middle age and with the development of dementia in old age. Blood pressure control in low-risk patients with stage I hypertension reduces the risk of dementia development, including Alzheimer’s disease. Therefore, improving the AH control in the population since younghood will be needed to influence the emerging cognitive dysfunction pandemic.

Keywords:

dementia – prevention – arterial hypertension – cognitive dysfunction – blood pressure control

Zdroje

1. Petersen RC, Lopez O, Armstrong MJ et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126-135.

2. Livingston G, Huntley J, Sommerlad A et al. Dementia prevention, intervention, and care: 2020 report of the <em>Lancet</em> Commission. The Lancet. 2020;396(10248):413-446.

3. Iadecola C, Yaffe K, Biller J et al. Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association. Hypertension (Dallas, Tex : 1979). 2016;68(6):e67-e94.

4. Schaare HL, Kharabian Masouleh S, Beyer F et al. Association of peripheral blood pressure with gray matter volume in 19- to 40-year‑old adults. Neurology. 2019;92(8):e758-e773.

5. Lane CA, Barnes J, Nicholas JM et al. Associations between blood pressure across adulthood and late‑life brain structure and pathology in the neuroscience substudy of the 1946 British birth cohort (Insight 46): an epidemiological study. The Lancet Neurology. 2019;18(10):942-952.

6. Shang X, Hill E, Zhu Z et al. The Association of Age at Diagnosis of Hypertension With Brain Structure and Incident Dementia in the UK Biobank. Hypertension. 2021;78(5):1463-1474.

7. Maillard P, Mitchell GF, Himali JJ, et al. Effects of Arterial Stiffness on Brain Integrity in Young Adults From the Framingham Heart Study. Stroke. 2016;47(4):1030-1036.

8. Suvila K, Lima JAC, Yano Y, Tan ZS, Cheng S, Niiranen TJ. Early‑but Not Late‑Onset Hypertension Is Related to Midlife Cognitive Function. Hypertension. 2021;77(3):972-979.

9. Swan GE, Carmelli D, Larue A. Systolic blood pressure tracking over 25 to 30 years and cognitive performance in older adults. Stroke. 1998;29(11):2334-2340.

10. Gottesman RF, Schneider AL, Albert M et al. Midlife hypertension and 20-year cognitive change: the atherosclerosis risk in communities neurocognitive study. JAMA neurology. 2014;71(10):1218-1227.

11. Emdin CA, Rothwell PM, Salimi‑Khorshidi G et al. Blood Pressure and Risk of Vascular Dementia: Evidence From a Primary Care Registry and a Cohort Study of Transient Ischemic Attack and Stroke. Stroke. 2016;47(6):1429-1435.

12. Chen KH, Henderson VW, Stolwyk RJ, Dennerstein L, Szoeke C. Prehypertension in midlife is associated with worse cognition a decade later in middle‑aged and older women. Age and ageing. 2015;44(3):439-445.

13. Hebert LE, Scherr PA, Bennett DA et al. Blood pressure and late‑ life cognitive function change: a biracial longitudinal population study. Neurology. 2004;62(11):2021-2024.

14. Solfrizzi V, Panza F, Colacicco AM, et al. Vascular risk factors, incidence of MCI, and rates of progression to dementia. Neurology. 2004;63(10):1882-1891.

15. Lee CJ, Lee JY, Han K et al. Blood Pressure Levels and Risks of Dementia: a Nationwide Study of 4.5 Million People. Hypertension (Dallas, Tex : 1979). 2022;79(1):218-229.

16. van Dalen JW, Brayne C, Crane PK et al. Association of Systolic Blood Pressure With Dementia Risk and the Role of Age, U‑Shaped Associations, and Mortality. JAMA internal medicine. 2022;182(2):142-152.

17. Skoog I, Lernfelt B, Landahl S et al. 15-year longitudinal study of blood pressure and dementia. Lancet (London, England). 1996;347(9009):1141-1145.

18. Qiu C, von Strauss E, Winblad B, Fratiglioni L. Decline in blood pressure over time and risk of dementia: a longitudinal study from the Kungsholmen project. Stroke. 2004;35(8):1810-1815.

19. Walker KA, Sharrett AR, Wu A et al. Association of Midlife to Late‑ Life Blood Pressure Patterns With Incident Dementia. JAMA. 2019;322(6):535-545.

20. Scuteri A, Benetos A, Sierra C et al. Routine assessment of cognitive function in older patients with hypertension seen by primary care physicians: why and how- —a decision‑making support from the working group on ‘hypertension and the brain’ of the European Society of Hypertension and from the European Geriatric Medicine Society. Journal of hypertension. 2021;39(1).

21. Lee CJ, Hwang J, Kang CY et al. Protective effect of controlled blood pressure on risk of dementia in low‑ risk, grade 1 hypertension. Journal of hypertension. 2021;39(8):1662-1669.

22. Williams B, Mancia G, Spiering W et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). European heart journal. 2018; 39(33): 3021-3104.

23. Sierra C. Hypertension and the Risk of Dementia. Front Cardiovasc Med. 2020 Jan 31;7:5.