Vascular dementia, hypertension, and the brain

Abstract

Ischemic vascular dementia is a clinical syndrome of acquired intellectual impairment with ischemic cerebral injury resulting from occlusion of cerebral blood vessels and loss of cerebral tissue caused by cerebrovascular disease. With increasing life expectancy, the developed countries have experienced a shift towards a progressively older population. As the average age ofthe population increases, the prevalence of cerebrovascular disease and vascular dementia is likely to increase. The risk of vascular dementia seems to be correlated with the epidemiologic risk factors ofstroke, namely hypertension. Hypertension is thought to be directly associated with vascplar dementia and preliminary evidence suggests an association between elevated blood pressure and impairments in cognitive functioning. Recent investigations have found significant associations between hypertension and cerebral dilation and left hemisphere atrophy, and an increased incidence of white matter hyperintensities among hypertensives. Treatment and prevention ,of vascular dementia and cognitive dysfunction in the elderly require attention to cerebrovascular risk factors, particularly hypertension. Vascular dementias are potentially preventable and cases ofAlzheimer’s disease with vascular components are becoming increasingly recognized. [Neural Res 1997; 19: 471-480]