Effects of Blood Pressure on Cognitive Performance: A Systematic Review

Abstract

Background: High blood pressure has been associated with an increased risk of developing cognitive impairment. However, this relationship is unclear. This study aims to systematically review the effects of blood pressure on executive functioning, language, memory, attention and processing speed. Methods: The review process was conducted according to the PRISMA-Statement, using the PubMed, PsycINFO, PsycARTICLES and MEDLINE databases. Restrictions were made by selecting studies, which included one or more cognitive measures and reported blood pressure recordings. Studies that included participants with medical conditions or people diagnosed with dementia, psychiatric disorders, stroke and head trauma were excluded. The review allows selecting fifty studies that included 107,405 participants. The results were reported considering different cognitive domains separately: global cognitive functioning, attention, processing speed, executive functions, memory and visuospatial abilities. Results: Higher blood pressure appears to influence cognitive performance in different domains in the absence of dementia and severe cardiovascular diseases, such as strokes. This relationship seems to be independent of demographic factors (gender and education), medical co-morbidity (diabetes), and psychiatric disorders (depression). Furthermore, it presents different patterns considering ageing. In the elderly, a sort of "cardiovascular paradox" is highlighted, which allows considering higher blood pressure as a protective factor for cognitive functioning. Conclusions: The results underline that higher blood pressure is associated with a higher risk of cognitive decline in people without dementia or stroke. These findings highlight the need to introduce early management of blood pressure, even in the absence of clinical hypertension, to prevent the risk of a decline of cognitive functioning typically associated with ageing. into dementia. Given the progressive ageing of the world population, the challenge of modern science is highlighted the factors associated with the evolution of cognitive impairment.Cognitive impairment appears to be amplified by several factors as the habit of smoking cigarettes [13,14], chronic use of alcohol [15], poor eating habits and obesity [16,17], inadequate exercise [18], chronic stress [19] or by some pathologies such as diabetes mellitus [20] or depression [21]. Moreover, the risk of cognitive impairment appears to increase in the presence of cardiovascular disorders, such as high blood pressure, cardiomyopathies, arteriosclerosis, cerebral infarcts and strokes [22]. Many studies have shown an association between vascular ageing indices, such as stiffness of the arteries and dysfunction of small vessels and cognitive decline [23]. The exposure to high blood pressure would damage the cerebral microcirculation, causing cognitive impairments [23].The mechanisms that can explain the relationship between high blood pressure and cognitive impairment are not wholly known. Some studies have shown associations be...

Cognitive impairment and its risk factors among Myanmar elderly using the Revised Hasegawa’s Dementia Scale: A cross-sectional study in Nay Pyi Taw, Myanmar

“…Reduction in cortical volume associated with increased white matter lesions in the elderly leads to executive function declination and cognitive impairment [34]. Moreover, aging is usually associated with NCDs such as hypertension and type 2 diabetes mellitus [29,35]. Hypertension and diabetes mellitus account for small or large vascular changes leading to cerebral-vascular accidents, strokes, cerebral hemorrhage or micro-cerebral infarcts.…”

“…Hypertension and diabetes mellitus account for small or large vascular changes leading to cerebral-vascular accidents, strokes, cerebral hemorrhage or micro-cerebral infarcts. As a result, cognitive function impairment is inevitable due to brain volume reduction [29,34,35]. Older age is the greatest unmodifiable risk factor for cognitive impairment [16], and should be taken into consideration in cognitive impairment prevention, as life expectancy is increasing worldwide.…”

“…Increased BMI associated with central obesity in the middle years of life has been observed as one of the risk factors for cognitive decline in older age by recent systematic reviews and meta-analyses [24,25]. Obesity in the middle years of life is usually related to hypertension, stroke, diabetes mellitus, and dyslipidemia [24,25,29,35]. Moreover, middle-age obesity is more likely to be associated with rapid brain aging and cerebral white matter atrophy due to the action of pro-inflammatory cytokines causing chronic inflammation and metabolic diseases [24,25,34].…”

“…Nowadays, the world's population is aging as advanced medical technological advances increase life expectancy, and age-related cognitive declination has become a major issue. Non-communicable diseases (NCDs) such as hypertension, diabetes mellitus, and obesity due to low physical activity accompany aging [24,25,29,35]. These are responsible for rapid brain aging and cerebral-vascular accidents, provoking the action of pro-inflammatory cytokines with the resultant chronic inflammation and cerebral white matter atrophy leading to cognitive impairment [24,25,34].…”

The Night Effect of Anger: Relationship with Nocturnal Blood Pressure Dipping

“…Accordingly, some studies suggested that Non-Dippers have a high sympathetic nervous system activity during wake time [11][12][13] and a lower parasympathetic nervous system activity throughout the sleep period [13,14].However, the exact causes of Non-Dipping are not fully clarified [15][16][17], and genetic, biological, environmental, and sociodemographic factors could affect it [18,19]. An increase in sympathetic nervous system activity appears to be associated with some psychological states [20,21] and cognitive dysfunctions [22,23]. It is well known that some psychological factors, such as hostility, depression, anxiety, dysfunctional coping strategies, and emotional dysregulation, appear to have a role in both cardiovascular events and the development and maintenance of hypertension [24][25][26][27][28][29].…”