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High Blood Pressure May Impair Cognitive Function and Pose Risk for Alzheimer’s

Summary: A new study reports high blood pressure in middle age may lead to cognitive impairment and could be a risk factor for Alzheimer’s disease.

Source: Loyola University Health System.

High blood pressure in middle age can lead to impaired cognition and is a potential risk factor for Alzheimer’s disease, according to a statement from the American Heart Association co-authored by Loyola Medicine neurologist José Biller, MD.

Dr. Biller is a member of the multidisciplinary panel of experts that wrote the statement, published in the heart association journal Hypertension. Dr. Biller is chair of the department of neurology of Loyola University Chicago Stritch School of Medicine. The panel is chaired by Constantino Iadecola, MD, of Weill Cornell Medicine and co-chaired by Kristine Yaffe, MD, of the University of California San Francisco.

Dementia affects an estimated 30 to 40 million people worldwide, and the number is expected to triple by 2050 due to an aging population and other factors.

An estimated 80 million people in the United States have hypertension, and the brain is among the organs most affected. Except for age, hypertension is the most important risk factor for vascular problems in the brain that lead to stroke and dementia.

There is consistent evidence that chronic high blood pressure during middle age (40 to 64) is associated with altered cognitive function in both middle age and late life (65 to 84). Cognitive abilities that are affected include memory, speed of processing and executive function (ability to organize thoughts, manage time, make decisions, etc.)

Image shows blood pressure machine.

The effect of high blood pressure in late life is less clear. Some studies suggest it’s harmful, while other research suggests it may improve cognition. This highlights “the complexities of recommending uniform levels of blood pressure across the life course,” the expert panel wrote. NeuroscienceNews.com image is for illustrative purposes only.

The effect of high blood pressure in late life is less clear. Some studies suggest it’s harmful, while other research suggests it may improve cognition. This highlights “the complexities of recommending uniform levels of blood pressure across the life course,” the expert panel wrote.

Observational studies have demonstrated that high blood pressure causes atherosclerosis (hardening of the arteries) and other damage to the brain’s blood vessels, leading to reduced blood flow to brain cells. But evidence from clinical trials that treating blood pressure improves cognition is not conclusive.

After carefully reviewing available studies, the panel concluded there are not enough data to make evidence-based recommendations. However, judicious treatment of high blood pressure, taking into account goals of care and the patient’s individual characteristics, “seems justified to safeguard vascular health and, as a consequence, brain health,” the panel concluded.

The paper is titled, “Impact of hypertension on cognitive function: a scientific statement from the American Heart Association.”

About this Alzheimer’s disease research article

Source: Jim Ritter – Loyola University Health System
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association” by Costantino Iadecola, Kristine Yaffe, José Biller, Lisa C. Bratzke, Frank M. Faraci, Philip B. Gorelick, Martha Gulati, Hooman Kamel, David S. Knopman, Lenore J. Launer, Jane S. Saczynski, Sudha Seshadri, Adina Zeki Al Hazzouri and on behalf of the American Heart Association Council on Hypertension; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council in Hypertension. Published online October 10 2016 doi:10.1161/HYP.0000000000000053

Cite This NeuroscienceNews.com Article
Loyola University Health System “High Blood Pressure May Impair Cognitive Function and Pose Risk for Alzheimer’s.” NeuroscienceNews. NeuroscienceNews, 29 October 2016.
<http://neurosciencenews.com/blood-pressure-alzheimers-5386/>.
Loyola University Health System (2016, October 29). High Blood Pressure May Impair Cognitive Function and Pose Risk for Alzheimer’s. NeuroscienceNew. Retrieved October 29, 2016 from http://neurosciencenews.com/blood-pressure-alzheimers-5386/
Loyola University Health System “High Blood Pressure May Impair Cognitive Function and Pose Risk for Alzheimer’s.” http://neurosciencenews.com/blood-pressure-alzheimers-5386/ (accessed October 29, 2016).

Abstract

Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association

Background
Age-related dementia, most commonly caused by Alzheimer disease or cerebrovascular factors (vascular dementia), is a major public health threat. Chronic arterial hypertension is a well-established risk factor for both types of dementia, but the link between hypertension and its treatment and cognition remains poorly understood. In this scientific statement, a multidisciplinary team of experts examines the impact of hypertension on cognition to assess the state of the knowledge, to identify gaps, and to provide future directions.

Methods Authors with relevant expertise were selected to contribute to this statement in accordance with the American Heart Association conflict-of-interest management policy. Panel members were assigned topics relevant to their areas of expertise, reviewed the literature, and summarized the available data.

Results
Hypertension disrupts the structure and function of cerebral blood vessels, leads to ischemic damage of white matter regions critical for cognitive function, and may promote Alzheimer pathology. There is strong evidence of a deleterious influence of midlife hypertension on late-life cognitive function, but the cognitive impact of late-life hypertension is less clear. Observational studies demonstrated a cumulative effect of hypertension on cerebrovascular damage, but evidence from clinical trials that antihypertensive treatment improves cognition is not conclusive.

Conclusions After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations. However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.

“Impact of Hypertension on Cognitive Function: A Scientific Statement From the American Heart Association” by Costantino Iadecola, Kristine Yaffe, José Biller, Lisa C. Bratzke, Frank M. Faraci, Philip B. Gorelick, Martha Gulati, Hooman Kamel, David S. Knopman, Lenore J. Launer, Jane S. Saczynski, Sudha Seshadri, Adina Zeki Al Hazzouri and on behalf of the American Heart Association Council on Hypertension; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council in Hypertension. Published online October 10 2016 doi:10.1161/HYP.0000000000000053

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