Correlates of cognitive status of old patients with isolated systolic hypertension

Seux, Marie-Laure; Thijs, Lutgarde; Forette, Françoise; Staessen, Jan A.; Birkenhäger, W. H.; Bulpitt, Christopher J.; Girerd, Xavier; Jääskivi, Matti; Vanhanen, Hannu; Kivinen, Paula; Yodfat, Y; Vänskä, O; Antikaínen, Riitta; Laks, Toivo; Webster, J; Hakamäki, T; Lehtomäki, Erkki; Lilov, Emil; Grigorov, M.; Janculova, Krassimira; Halonen, K.; Kohonen-Jalonen, Paula; Kermowa, Rumiana; Nachev, C; Tuomilehto, Jaakko

doi:10.1097/00004872-199816070-00009

Cited by 81 publications

(44 citation statements)

References 40 publications

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“…However opinion remains divided, because of methodological issues including: (1) differences in the study populations (age, level of education, duration of hypertension, volunteers, referrals, or population samples) (2) differences in the neuropsychological tests used to evaluate the participants; and (3) the use of cross-sectional rather than longitudinal study designs. 79,80 Cross-sectional studies Many cross-sectional studies have attempted to determine whether cognitive function is related to hypertension. 79,[81][82][83][84][85][86][87][88][89][90][91] Cognitive function has been found to be negatively, positively or not associated with systolic blood pressure or diastolic blood pressure (Table 4).…”

Section: Hypertension and Cognitive Functionmentioning

confidence: 99%

“…79,80 Cross-sectional studies Many cross-sectional studies have attempted to determine whether cognitive function is related to hypertension. 79,[81][82][83][84][85][86][87][88][89][90][91] Cognitive function has been found to be negatively, positively or not associated with systolic blood pressure or diastolic blood pressure (Table 4). In the studies that demonstrated a significant positive correlation between cognitive impairment and hypertension, the neuropsychological domains predominantly affected were learning and memory, attention and mental flexibility.…”

Section: Hypertension and Cognitive Functionmentioning

confidence: 99%

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Cerebral complications of hypertension

Rigaud

Staessen

et al. 2000

J Hum Hypertens

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Ischaemic and degenerative brain diseases are a major health problem leading to a devastating loss of autonomy. Hypertension has been shown to carry an increased risk not only for cerebrovascular morbidity and mortality but also for cognitive impairment and dementia. Although diastolic blood pressure is considered an important risk factor, it is now clear that isolated systolic hypertension and elevated pulse pressure also play an important role in the development of brain complications. Therefore the treatment of these conditions must urgently become a widespread tool of prevention. All the randomised placebo-controlled trials completed for the last 30 years have shown a reduction in fatal and/or non-fatal strokes. In the most recent trials in isolated systolic hypertension in older patients, the benefit was even greater because of the higher risk in these populations. The new classes of drugs, in particular, calcium-channels blockers and angiotensin-

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Section: Hypertension and Cognitive Functionmentioning

confidence: 99%

Section: Hypertension and Cognitive Functionmentioning

confidence: 99%

Cerebral complications of hypertension

Rigaud

Staessen

et al. 2000

J Hum Hypertens

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“…Finally, the vascular dementia project, set up in the framework of the Syst-Eur trial, [30][31][32] investigated whether antihypertensive drug treatment could reduce the incidence of dementia. Compared with placebo (n = 1180), active treatment (n = 1238) reduced the rate of dementia by 50% from 7.7 to 3.7 cases per 1000 patient-years (21 vs 11 patients in the intention-to-treat analysis, P = 0.05).…”

Section: Discussionmentioning

confidence: 99%

Systolic Hypertension in Europe (Syst-Eur) Trial Phase 2: objectives, protocol, and initial progress

Gąsowski¹,

Staessen²,

Celis³

et al. 1999

J Hum Hypertens

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on behalf of the Systolic Hypertension in Europe InvestigatorsThe Systolic Hypertension in Europe (Syst-Eur) trial proved that blood pressure (BP) lowering therapy starting with nitrendipine reduces the risk of cardiovascular complications in older (у60 years) patients with isolated systolic hypertension (systolic BP у160 mm Hg and diastolic BP Ͻ95 mm Hg). After the completion of the Syst-Eur trial on 14 February 1997, 3506 consenting patients (93.0% of those eligible) were enrolled in phase 2 of the Syst-Eur trial. This open follow-up study aims to confirm the safety of long-term antihypertensive therapy based on a dihydropyridine. To lower the sitting systolic BP below 150 mm Hg (target BP), the first-line agent nitrendipine (10-40 mg/day) may be associated with enalapril (5-20 mg/day), hydrochlorothiazide (12.5-25 mg/day), both add-on study drugs, or if required any other antihypertensive agent. On 1 November 1998, 3248 patients were still being followed, 86 patients had proceeded to non-supervised follow-up, and 43 had died. The median follow-up in Syst-Eur 2 was 14.3 months. At Keywords: calcium-channel blockade; elderly; dihydropyridine; isolated systolic hypertension IntroductionIn 1989 the European Working Party on High Blood Pressure in the Elderly started the placebo-controlled double-blind Systolic Hypertension in Europe trial (Syst-Eur). 1 Active treatment was initiated with the dihydropyridine calcium-channel blocker nitrendipine 2 with the possible addition of enalapril, hydrochlorothiazide or both drugs. The Syst-Eur trial stopped on 14 February 1997 according to predefined rules, 3 because the second of four planned interim analyses had shown a significant benefit for stroke, the primary end-point. 1 At the Syst-Eur investigators meeting in March 1997, the decision was taken to keep the Syst-Eur patients in followup. This article summarizes the rationale and protocol of this study, named Systolic Hypertension in Correspondence: Dr Jan A Staessen, Klinisch Laboratorium Hypertensie, Inwendige Geneeskunde-Cardiologie, UZ Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium Received 14 October 1998; accepted 21 October 1998 the last available visit, systolic/diastolic BP in the patients formerly randomised to placebo (n = 1682) or active treatment (n = 1824), had decreased by 13.2/5.2 mm Hg and by 4.6/1.6 mm Hg, respectively, so that the between-group BP difference was 1.7 mm Hg systolic (95% Cl: 0.8 to 2.6 mm Hg; P Ͻ 0.001) and 0.9 mm Hg diastolic (95% Cl: 0.4 to 1.5 mm mm Hg; P Ͻ 0.001). At the beginning of Syst-Eur 2, the goal BP was reached by 25.4% and 50.6% of the former placebo and activetreatment groups; at the last visit these proportions were 55.9% and 63.1%, respectively. At that moment, 45.9% of the patients were on monotherapy with nitrendipine, 29.3% took nitrendipine in combination with other study drugs. Until the end of 2001, BP control of the Syst-Eur 2 patients will be further improved. Cardiovascular complications and adverse events, such as cancer or gastro-intestinal bleeding, wi...

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“…A close association has also been shown between silent stroke (evidenced by cerebral white matter lesions) and echocardiographic LVH in 62 asymptomatic middle-aged patients with hypertension (Sierra, 2002). Many epidemiologic studies have indicated a correlation between blood pressure level and cognitive decline or dementia later in life (Starr, 1993;Seux, 1998;Postner, 2002;Hanon, 2003;Piguet, 2003;Whitmer, 2005). The importance of lowering blood pressure in hypertensive subjects is well-known, but the relationship between hypertension and cognitive function is still controversial.…”

Section: Hypertension-induced Brain Damagementioning

confidence: 99%