The Prevention of Dementia With Antihypertensive Treatment&lt;subtitle&gt;New Evidence From the Systolic Hypertension in Europe (Syst-Eur) Study&lt;/subtitle&gt;

Forette, Françoise

doi:10.1001/archinte.162.18.2046

Cited by 784 publications

(170 citation statements)

References 55 publications

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“…Treatment of hypertension protects against cognitive decline even in the absence of stroke [92,93,94]. Treatment of hypertension in the elderly caused no deleterious effects on cognition, mood, and quality of life [95,96,97,98].…”

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

“…Treatment of hypertension in the elderly caused no deleterious effects on cognition, mood, and quality of life [95,96,97,98]. On the contrary, Forette et al [92] confirmed that treatment of systolic hypertension with nitrendipine, a long-acting dihydropyridine calcium channel blocker, protects against dementia in older patients. Compared with placebo, long-term antihypertensive therapy reduced the risk of dementia by 55%, from 7.4 to 3.3 cases per 1,000 patient-years.…”

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

“…After adjustment for sex, age, education, and entry blood pressure, the relative hazard rate associated with the use of nitrendipine was 0.38 (95% CI, 0.23–0.64; p < 0.001). Treatment of 1,000 patients for 5 years can prevent 20 cases of dementia (95% CI, 7–33) [92, 93]. The most appropriate levels of blood pressure control remain undecided.…”

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

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Vascular Dementia Prevention: A Risk Factor Analysis

Román¹

2005

Cerebrovasc Dis

132

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Brain injury from ischemic or hemorrhagic cerebrovascular disease (CVD) produces decline in cognitive functions and vascular dementia (VaD). Likewise, CVD may cause VaD from hypoperfusion of susceptible brain areas. CVD may also worsen degenerative dementias such as Alzheimer’s disease. Significant advances have been made in the identification and control of risk factors for stroke and cardiovascular disease. The main risk factors for VaD include age, hypertension and absence of antihypertensive medication, diabetes, cigarette smoking, history of cardiovascular disease (coronary heart disease, congestive heart failure, peripheral vascular disease), atrial fibrillation, left ventricular hypertrophy, hyperhomocysteinemia, orthostatic hypotension, cardiac arrhythmias, hyperfibrinogenemia, and sleep apnea. Recently identified risk factors include chronic infection and elevation of C-reactive protein, particularly in patients with diabetes. Evidence from controlled clinical trials strongly suggests that control of vascular risk factors, in particular hypertension, could prevent the development of dementia.

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Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

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Vascular Dementia Prevention: A Risk Factor Analysis

Román¹

2005

Cerebrovasc Dis

132

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“…The majority of the dementias avoided were due to Alzheimer’s, so that 19 cases per 1,000 patients per 5 years were preempted. In a subsequent follow-up, similar benefits continued to be maintained [69]. In the PROGRESS study [70] a significant benefit was obtained in the active arm; the RRR for the incidence of serious cognitive deterioration was 19% and for dementia 12%.…”

Section: Other Benefits Of Treatment With Antihypertensive Drugsmentioning

confidence: 94%

Blood Pressure as a Risk Factor for Stroke and the Impact of Antihypertensive Treatment

Gil‐Núñez¹,

Vivancos-Mora²

2005

Cerebrovasc Dis

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We review hypertension and blood pressure levels as risk factors for stroke and the impact of antihypertensive treatment on the prevention of first stroke event and of recurrent stroke, not only with respect to the prevention of vascular events but also the prevention of cognitive deterioration, dementia, and physical disability. We review whether pharmacological blockage of the renin-angiotensin system has additional long-term effects over that of control of blood pressure levels alone, and the benefit of treatment with antihypertensive drugs in normotensive patients. Therapeutic objectives for blood pressure levels after stroke are defined together with recommendations of drugs and doses which have been demonstrated to have the greatest benefit in the prevention of stroke.

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“…In the Systolic Hypertension in Europe study (Syst-Eur), a double-blind placebo-controlled trial, the treatment of isolated hypertension in >60-year-old subjects with nitrendipine significantly reduced the incidence of dementia [119]. A 2-year open-label extension of Syst-Eur showed similar results [120]. In the SCOPE study [121], the blood pressure difference between patients treated with candesartan and patients in control groups was 3.2/1.6 mm Hg, and no effect on cognition was observed over a mean of 3.7 years.…”

Section: Treatment Of Vadmentioning

confidence: 99%

Neuroprotection in Vascular Dementia

et al. 2006

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Vascular dementia (VaD) is the second most common form of dementia after Alzheimer’s disease (AD), and one of the major causes of mental and physical disability in developed countries. As such, the identification and implementation of strategies which prevent the development of the condition or enable improvements in patients with VaD are healthcare objectives of the first order. VaD is now regarded as a combined group of clinical-pathological entities rather than one disease, that is, multiple pathogenic mechanisms and lesion types underlie a cognitive impairment of vascular origin. The clinical diagnosis of VaD is complex and difficult because of the heterogeneous nature of its clinical presentation and progression and the low sensitivity of existing clinical criteria. Moreover, there is growing evidence of the epidemiological significance of mixed forms of dementia, and that ischemic processes may precipitate and exacerbate cognitive impairment in AD. Numerous compounds have been proposed as potentially useful in the treatment of patients with VaD, comprising vasodilatative, antithrombotic, hemorrheological, nootropic, antiserotoninergic and, most recently, antiglutamatergic and cholinergic approaches. In spite of some initially favorable reports based on the use of memantine, donepezil and galantamine, there is as yet no conclusive evidence of a definitive treatment for VaD. Unsatisfactory results from VaD drug trials may be attributed in part to the diversity of the patients included (underlying pathogenic mechanisms, number, type, and location of vascular lesions), and to methodological limitations in the design of the trials (outcome measures, end-points, size, follow-up period). The treatment of modifiable vascular risk factors – hypertension, diabetes mellitus, hypercholesterolemia and heart disease – is an important strategy for the reduction of the risk of dementia, and is likely to slow the progress of cognitive decline.

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The Prevention of Dementia With Antihypertensive Treatment<subtitle>New Evidence From the Systolic Hypertension in Europe (Syst-Eur) Study</subtitle>

Cited by 784 publications

References 55 publications

Vascular Dementia Prevention: A Risk Factor Analysis

Vascular Dementia Prevention: A Risk Factor Analysis

Blood Pressure as a Risk Factor for Stroke and the Impact of Antihypertensive Treatment

Neuroprotection in Vascular Dementia

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