High Morning and Bedtime Home Blood Pressures Strongly Predict for Post-Stroke Cognitive Impairment

Yamamoto, Yasumasa; Nagakane, Yoshinari; Tomii, Yasushi; Akiguchi, Ichiro

doi:10.1016/j.jstrokecerebrovasdis.2016.04.001

Cited by 9 publications

(8 citation statements)

References 25 publications

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“…A study that focusing on BP and poststroke cognitive impairment found that high home BP and multiple LI were significantly independent predictors for the progression of both cognitive impairment and stroke recurrence. [ 44 ] Finally, the Ohasama study revealed that, at a 7-year follow-up appointment, LI was a better indicator than WML of declines in motivation, interest, and reaction to the environment. [ 45 ]…”

Section: Acunar I Nfarctmentioning

confidence: 99%

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

Yang

Dong

Lyu

et al. 2018

Chinese Medical Journal

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Objective:Alzheimer's disease and vascular dementia are responsible for more than 80% of dementia cases. These two conditions share common risk factors including hypertension. Cerebral small vessel disease (CSVD) is strongly associated with both hypertension and cognitive impairment. In this review, we identify the pathophysiological changes in CSVD that are caused by hypertension and further explore the relationship between CSVD and cognitive impairment.Data Sources:We searched and scanned the PubMed database for recently published literatures up to December 2017. We used the keywords of “hypertension”, “cerebral small vessel disease”, “white matter lesions”, “enlarged perivascular spaces”, “lacunar infarcts”, “cerebral microbleeds”, and “cognitive impairment” in the database of PubMed.Study Selection:Articles were obtained and reviewed to analyze the hypertension-induced pathophysiological changes that occur in CSVD and the correlation between CSVD and cognitive impairment.Results:In recent years, studies have demonstrated that hypertension-related changes (e.g., small vascular lesions, inflammatory reactions, hypoperfusion, oxidative stress, damage to autoregulatory processes and the blood-brain barrier, and cerebral amyloid angiopathy) can occur over time in cerebral small vessels, potentially leading to lower cognitive function when blood pressure (BP) control is poor or lacking. Both isolated and co-occurrent CSVD can lead to cognitive deterioration, and this effect may be attributable to a dysfunction in either the cholinergic system or the functionality of cortical and subcortical tracts.Conclusions:We explore the currently available evidence about the hypertensive vasculopathy and inflammatory changes that occur in CSVD. Both are vital prognostic indicators of the development of cognitive impairment. Future studies should be performed to validate the relationship between BP levels and CSVD progression and between the numbers, volumes, and anatomical locations of CSVD and cognitive impairment.

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Section: Acunar I Nfarctmentioning

confidence: 99%

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

Yang

Dong

Lyu

et al. 2018

Chinese Medical Journal

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“…Many observational studies report hypertension to be an important risk factor for dementia (56)(57)(58) and in a recent meta-analysis of randomized clinical trials, blood pressure lowering with antihypertensive agents compared with control was significantly associated with a lower risk of incident dementia or CI (59). The relationship between hypertension and cognitive decline may be mediated through cerebrovascular disease (60,61) or via augmentation of neurodegenerative mechanisms. At autopsy, hypertensive older adults also have evidence of greater AD pathology in the brain, including neurofibrillary tangles and neuritic amyloid-beta (Aβ) plaques (62).…”

Section: Hypertensionmentioning

confidence: 99%

Disentangling the Relationship Between Chronic Kidney Disease and Cognitive Disorders

Kelly

Rothwell

2022

Front. Neurol.

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Chronic kidney disease (CKD) is a rapidly rising global health burden that affects nearly 40% of older adults. Epidemiologic data suggest that individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing cognitive disorders and dementia, and thus represent a vulnerable population. It is currently unknown to what extent this risk may be attributable to a clustering of traditional risk factors such as hypertension and diabetes mellitus leading to a high prevalence of both symptomatic and subclinical ischaemic cerebrovascular lesions, or whether other potential mechanisms, including direct neuronal injury by uraemic toxins or dialysis-specific factors could also be involved. These knowledge gaps may lead to suboptimal prevention and treatment strategies being implemented in this group. In this review, we explore the mechanisms of susceptibility and risk in the relationship between CKD and cognitive disorders.

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“…The progression of periventricular white matter lesions in patients with hypertension relates to cognitive impairment (especially executive function), whereas there is no association between baseline periventricular white matter lesions and cognitive dysfunction 42. High home BP and multiple lacunar infarcts are significantly independent predictors for the progression of both cognitive impairment and stroke recurrence 43. Hypertensive vasculopathy and cerebral amyloid angiopathy may also combine to cause cognitive decline with variable phenotype depending on the location and number of cerebral microbleeds 44…”

Section: Cognitive Impairment and Dementiamentioning

confidence: 99%

Blood pressure and the brain: the neurology of hypertension

Kelly

Rothwell

2019

Pract Neurol

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Hypertension affects more than one in four adults. The brain is an early target of hypertension-induced organ damage, and may manifest as stroke, subclinical cerebrovascular abnormalities and dementia. Hypertension-related small vessel disease can cause vascular dementia and can potentiate Alzheimer’s pathology, lowering the threshold at which signs and symptoms manifest. Many hypertensive emergencies may also have a neurological presentation, such as hypertensive encephalopathy, haemorrhagic stroke or pre-eclampsia. Here we highlight the importance of blood pressure in maintaining brain health and the brain’s role in controlling blood pressure.

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High Morning and Bedtime Home Blood Pressures Strongly Predict for Post-Stroke Cognitive Impairment

Cited by 9 publications

References 25 publications

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

Hypertension-Induced Cerebral Small Vessel Disease Leading to Cognitive Impairment

Disentangling the Relationship Between Chronic Kidney Disease and Cognitive Disorders

Blood pressure and the brain: the neurology of hypertension

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