Abstract
Hypertension, particularly midlife high blood pressure, has been related to a higher risk of cognitive decline and dementia, including Alzheimer disease. However, these associations are complex and not fully elucidated. Cerebral small vessel disease emerges as one of the most important causes. Several observational studies have shown the potential beneficial role of antihypertensive treatment in preventing cognitive decline. However, randomized clinical trials (RCTs) have shown controversial results without proving nor disproving the association. On the other hand, in very elderly or frail people some studies have observed a relationship between low blood pressure and worse cognitive function. The optimal systolic and diastolic blood pressure values for protecting cognitive function, especially in elderly people, are not known.
Highlights
Regardless of age, hypertension is undoubtedly the vascular risk factor (VRF) most closely related to cerebrovascular pathology [1]
The role of blood pressure (BP) on cognitive function appears to differ with age
In elderly population there are some studies that suggest that episodes of hypotension or an excessive BP reduction can cause or worsen a decline in cognitive function
Summary
Hypertension & Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona (IDIBAPS), University of Barcelona, Barcelona, Spain. Hypertension, midlife high blood pressure, has been related to a higher risk of cognitive decline and dementia, including Alzheimer disease. These associations are complex and not fully elucidated. Several observational studies have shown the potential beneficial role of antihypertensive treatment in preventing cognitive decline. In very elderly or frail people some studies have observed a relationship between low blood pressure and worse cognitive function. The optimal systolic and diastolic blood pressure values for protecting cognitive function, especially in elderly people, are not known
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