Hypertension and Dementia: Epidemiological and Experimental Evidence Revealing a Detrimental Relationship

Perrotta, Marialuisa; Lembo, Giuseppe; Carnevale, Daniela

doi:10.3390/ijms17030347

Cited by 60 publications

(46 citation statements)

References 84 publications

(110 reference statements)

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“…The cases in our study had a higher prevalence of comorbidities than the controls even before a dementia diagnosis. A previous study has noted the association between hypertension and dementia [41]. Similarly, in this study, we observed a significantly higher prevalence of hypertension in the cases (67% versus 49% in the controls) during the look-back period.…”

Section: Discussionsupporting

confidence: 85%

The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea

Park

Song

et al. 2017

PLoS ONE

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Dementia is a major concern among growing chronic diseases in the aging society and its association with polypharmacy has not been adequately assessed. The objective of this study was to determine the association between polypharmacy and dementia through multiple statistical approaches. We conducted a nested case-control study for newly diagnosed dementia cases using the South Korean National Health Insurance Service sample cohort database (2002–2013, n = 1,025,340). Interactions between polypharmacy (an average use of ≥5 prescription drugs daily) and comorbidities or potentially inappropriate medications (PIMs) were tested. The odds ratios (ORs) for dementia were analyzed according to the presence of comorbidities, PIM uses, the average number of prescribed daily drugs, and significant interactions with polypharmacy using univariate and multiple logistic regression analyses. A higher prevalence of comorbidities, history of PIM use, higher PIM exposure, and higher proportion of polypharmacy were noted among cases than in controls. In the univariate analysis, the OR for dementia increased significantly with the increase in the number of prescribed drugs [1–<5 drugs: 1.72, 95% confidence interval (CI): 1.56–1.88; 5–<10 drugs: 2.64, 95% CI: 2.32–3.05; ≥10 drugs: 3.35, 95% CI: 2.38–4.71; <1 drug used as reference]. Polypharmacy was correlated with comorbidities and PIM use, and significant interactions were observed between polypharmacy and anticholinergics; H2-receptor antagonists; and comorbidities such as hypertension, peripheral or cerebrovascular disease, congestive heart failure, hemiplegia, diabetes, depression, all other mental disorders, chronic obstructive pulmonary disease, peptic ulcer disease, and chronic liver disease (p<0.001). In the multiple regression analysis, most cases exhibited increasing ORs for dementia with increasing polypharmacy levels. Moreover, the increase in OR was more evident in the absence of drugs or comorbidities that showed significant interactions with polypharmacy than in their presence. Polypharmacy increases the risk of PIM administration, and as some PIMs may have cognition-impairing effects, prolonged polypharmacy may result in dementia. Therefore, efforts are needed to limit or decrease the prescription of medications that have been associated with risk of dementia in the elderly.

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Section: Discussionsupporting

confidence: 85%

The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea

Park

Song

et al. 2017

PLoS ONE

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“…Hypertension is a risk factor for cognitive decline and dementia substantially because of its ability to affect brain homeostasis, both at the structural and functional level (Perrotta et al, ). During the last few years, a growing body of evidence suggest an involvement of uric acid (UA) in the pathophysiology of organ damage in hypertensive patients (Kanbay et al, ; Desideri et al, ; Borghi et al, ).…”

mentioning

confidence: 99%

Uric Acid Amplifies Aβ Amyloid Effects Involved in the Cognitive Dysfunction/Dementia: Evidences From an Experimental Model In Vitro

Desideri

Gentile

Antonosante

et al. 2016

Journal Cellular Physiology

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There is still a considerable debate concerning whether uric acid is neuroprotective or neurotoxic agent. To clarify this topic, we tested the effects of uric acid on neuronal cells biology by using differentiated SHSY5Y neuroblastoma cells incubated with amyloid β to reproduce an in vitro model of Alzheimer's disease. The incubation of cells with uric acid at the dose of 40 µM or higher significantly reduced cell viability and potentiated the proapoptotic effect of amyloid β. Finally, uric acid enhanced the generation of 4-hydroxynonenal and the expression of PPARβ/δ promoted by amyloid β, indicating a prooxidant effects. In conclusion, uric acid could exert a detrimental influence on neuronal biology being this influence further potentiated by the concomitant exposure to neurotoxic stimuli. This effect is evident for uric acid concentrations close to those achievable in cerebrospinal fluid in presence of mild hyperuricemia thus suggesting a potential role of uric acid in pathophysiology of cognitive dysfunction. These effects are influenced by the concentrations of uric acid and by the presence of favoring conditions that commonly occur in neurodegenerative disorders and well as in the aging brain, including increased oxidative stress and exposure to amyloid β. J. Cell. Physiol. 232: 1069-1078, 2017. © 2016 Wiley Periodicals, Inc.

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“…Many studies have shown a positive correlation between high blood pressure and cognitive function (Perrotta, Lembo, & Carnevale, ), and hypertension could generate small vessel disease, which was a major cause of vascular cognitive impairment. High TG was reported to be associated with cognitive impairment and diabetes, associated with microvascular complications, was also closely related to cognitive dysfunction (Umegaki et al., ).…”

Section: Discussionmentioning

confidence: 99%

Association of neck circumference and cognitive impairment among Chinese elderly

Chen

Jiang

et al. 2018

Brain and Behavior

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ObjectivesTo investigate the association between neck circumference (NC) and cognitive impairment and interactions between relevant variables to the risk of cognitive impairment.MethodsA population‐based survey was conducted among elderly inhabitants aged 60 years and over from a community in Shanghai suburb. Multivariate logistic regression analyses were performed to evaluate associations and log likelihood ratio tests to examine interactions.ResultsCognitive impairment was identified in 269 (10.8%) subjects from 2,500 participants. Higher BMI (OR = 1.55; 95% CI = 1.11–2.16), higher WHR (OR = 1.44; 95% CI = 1.07–1.95), and higher total cholesterol (TC) (OR = 1.52; 95% CI = 1.09–2.13) were significantly associated with the increased risk of cognitive impairment. Significant interactions were observed between TC and a few other relevant variables, respectively.Conclusions NC was associated with the high risk of cognitive impairment. Additive effects of NC with TC on cognitive impairment were observed.

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Hypertension and Dementia: Epidemiological and Experimental Evidence Revealing a Detrimental Relationship

Cited by 60 publications

References 84 publications

The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea

The Association between Polypharmacy and Dementia: A Nested Case-Control Study Based on a 12-Year Longitudinal Cohort Database in South Korea

Uric Acid Amplifies Aβ Amyloid Effects Involved in the Cognitive Dysfunction/Dementia: Evidences From an Experimental Model In Vitro

Association of neck circumference and cognitive impairment among Chinese elderly

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