Hypotension and cognitive impairment

Abstract

Systolic hypotension is selectively associated with cognitive impairment in older patients with heart failure. As early treatment of cardiac low-output states can reverse cognitive dysfunction, the routine management of heart failure should include systematic assessment of cognitive performance.

Fatores de risco cardiovascular, declínio cognitivo e alterações cerebrais detectadas através de técnicas de neuroimagem

“…Os fatores de risco cardiovascular constituem elementos de risco para AVCs silenciosos e lesões vasculares em substância branca cerebral, cuja localização poderia contribuir para o aparecimento de défi-cits cognitivos (Zuccala et al, 2001). Outro aspecto seria a presença de fibrilação atrial, que é freqüente na população idosa, e está associada ao desenvolvimento de quadros de DA e DMI (Ferro e Madureira, 2002).…”

Relationship between cognitive function and 6-minute walking test in older outpatients with chronic heart failure

“…Beyond the epidemiological observation, the mechanisms involved in this association are not fully understood. Some authors have stressed the role of low cardiac output and chronic hypotension as major causes of cerebral hypoperfusion and ischemia (12,13), enhanced by the impairment of cerebral blood flow auto-regulation frequently observed in CHF (14). Another mechanism which may contribute to cerebral damage is cardio-embolism, frequently detected in heart failure patients with atrial fibrillation (15) or apical ventricular thrombosis (16).…”

P3‐281: The Prevalence of Cognitive Impairment in Older Adults with Heart Failure

“…Prevalence estimates for CI among patients with HF vary widely from 5-75%, with most estimates falling between 25-46% (12)(13)(14)(15). Prior work examining HF's association with CI has emphasized a case-control study design using non-representative samples, including inpatients and those with a range of etiologies of HF.…”

“…Prior work examining HF's association with CI has emphasized a case-control study design using non-representative samples, including inpatients and those with a range of etiologies of HF. Furthermore, the assessment of cognition has not been standardized; investigators have employed a myriad of tools ranging from cognitive screens such as the Mini-Mental State Exam to abbreviated neuropsychological test batteries (15)(16)(17). Because of these and other limitations, it is currently difficult to confidently assess the true extent of CI among older adults with HF.…”