Hypertension and Cognitive Functioning

Abstract

Our objective is to characterize the development of the literature on hypertension and cognitive functioning from a historical perspective. This goal was stimulated by the review on “Historical Trends and Milestones in Hypertension Research” in the October 2012 issue of Hypertension .1 Our specific aims are threefold: (1) to trace and describe the history of this area of research; (2) to identify milestones in knowledge and methods; and (3) to discuss briefly how this literature translates into patient care. The topic is of major relevance to research and practice because hypertension is a well-known risk factor for decline in cognitive performance within the normal range of cognitive functioning, mild cognitive impairment (MCI) and dementia. It is important to emphasize 3 features of the review: (1) it is not designed as a critical review of the literature, but rather to describe the historical influences on our current knowledge base (poor, mediocre and outstanding papers from the past have all shaped our present); (2) word-count limitations require that we omit statistical detail except to emphasize effect sizes in pivotal papers; and (3) each milestone topic is addressed by noting the earliest work then followed by examples of papers representing pivotal events. A number of comprehensive reviews of this literature are available,2–6 including a seminal paper summarizing the formative years of this research.7 Please see http://hyper.ahajournals.org for citations to additional reviews of the literature and papers published in Hypertension . We recognize the importance of the emerging literature on hypotension and cognitive function, but refer the readers to previous reviews which include this topic.8–10 ### Measurement of Cognitive Functioning In this paper, the term cognitive performance is used to describe the outcome of studies measuring a full range of ability from low to high. The term cognitive functioning is used …