Hypertension and Cognitive Function

Obisesan, Thomas O.

doi:10.1016/j.cger.2009.03.002

Cited by 59 publications

(42 citation statements)

References 132 publications

(157 reference statements)

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“…Given that AD pathology begins ∼15 years before the clinical phenotype, the observed effects of SBP in the CN group may also be an adaptive mechanism prior to a yet undetermined blood pressure threshold. As in previous reports of a nonlinear (U-shaped) relationship of blood pressure to cognitive performance in older adults [53], a U-shaped relationship of SBP and DBP to hippocampal volume was also evident in our analyses. These findings are congruent with reports of inverse relationships of blood pressure to concentrations of hippocampal glutamate (a crucial prerequisite of memory formation) [54] and to AD diagnosis years after blood pressure became elevated [55].…”

Section: Discussionsupporting

confidence: 88%

Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer’s Disease Neuroimaging Initiative (ADNI)

Ngwa

Fungwe

Ntekim

et al. 2018

Dement Geriatr Cogn Disord

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Background: It is increasingly evident that high blood pressure can promote reduction in global and regional brain volumes. While these effects may preferentially affect the hippocampus, reports are inconsistent. Methods: Using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), we examined the relationships of hippocampal volume to pulse pressure (PPR) and systolic (SBP) and diastolic (DBP) blood pressure according to apolipoprotein (APOE) ɛ4 positivity and cognitive status. The ADNI data included 1,308 participants: Alzheimer disease (AD = 237), late mild cognitive impairment (LMCI = 454), early mild cognitive impairment (EMCI = 254), and cognitively normal (CN = 365), with up to 24 months of follow-up. Results: Higher quartiles of PPR were significantly associated with lower hippocampal volumes (Q1 vs. Q4, p = 0.034) in the CN and AD groups, but with increasing hippocampal volume (Q1, p = 0.008; Q2, p = 0.020; Q3, p = 0.017; Q4 = reference) in the MCI groups. In adjusted stratified analyses among non-APOE ɛ4 carriers, the effects in the CN (Q1 vs. Q4, p = 0.006) and EMCI groups (Q1, p = 0.002; Q2, p = 0.013; Q3, p = 0.002; Q4 = reference) remained statistically significant. Also, higher DBP was significantly associated with higher hippocampal volume (p = 0.002) while higher SBP was significantly associated with decreasing hippocampal volume in the EMCI group (p = 0.015). Conclusion: Changes in PPR, SBP, and DBP differentially influenced hippocampal volumes depending on the cognitive and APOE genotypic categories.

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Section: Discussionsupporting

confidence: 88%

Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer’s Disease Neuroimaging Initiative (ADNI)

Ngwa

Fungwe

Ntekim

et al. 2018

Dement Geriatr Cogn Disord

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“…Studies in mice have indicated that accumulation of amyloid β might directly be enhanced by hypertension-induced vascular changes [56]. These mechanisms are discussed in more detail in a review by Dr. Obisesan [57].…”

Section: Hypertension and Cognitive Impairmentmentioning

confidence: 97%

The complex interplay of cardiovascular system and cognition: How to predict dementia in the elderly?

Kerola

Kettunen

Nieminen

2011

International Journal of Cardiology

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“…Some welldesigned randomized controlled trials (RCTs) have shown a positive correlation of antihypertensive therapy with the prevention or slowing of cognitive decline. The Perindopril Protection Against Recurrent Stroke Study (PROGRESS) showed a 19 % relative risk reduction in cognitive decline [27], a Heart Outcome Prevention Evaluation (HOPE) study showed a significant 41 % reduction in stroke-related cognitive decline [28], and a trial of HTN treatment in the elderly, the Systolic Hypertension in Europe (Syst-Eur) study showed a 50 % reduction in dementia incidence in the treatment group compared to placebo [29]. On the other hand, other RCTs have failed to show any significant prevention of cognitive decline with anti-HTN therapy.…”

Section: Antihypertensive Therapies and Cognitive Functionmentioning

confidence: 99%

Antihypertensive Therapies and Cognitive Function: a Review

2015

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Increasing life expectancy has made old age-related health problems like dementia and cognitive decline more prevalent, and these are rapidly becoming important causes of disability and poor quality of life, causing significant add-ons to health-care costs worldwide. Hypertension is the most important modifiable vascular risk factor for the development and progression of both cognitive decline and dementia. In many observational and randomized studies, antihypertensive therapies have been shown to be beneficial in slowing cognitive decline. However, due to observed discrepancies by these studies, there is a lack of consensus on the best antihypertensive strategy for the prevention or slowing of cognitive decline. It is also not clear whether the beneficial effect of antihypertensive therapy is due to the use of a specific class of agents or combination therapy. Thus, we present a comprehensive review of overall antihypertensive therapies and cognition and of the individual antihypertensive therapy classes with their specific protective mechanisms and available clinical evidence behind their effect on cognitive function.

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Hypertension and Cognitive Function

Cited by 59 publications

References 132 publications

Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer’s Disease Neuroimaging Initiative (ADNI)

Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer’s Disease Neuroimaging Initiative (ADNI)

The complex interplay of cardiovascular system and cognition: How to predict dementia in the elderly?

Antihypertensive Therapies and Cognitive Function: a Review

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