AHA review confirms hypertension link to cognitive impairment
medwireNews: The American Heart Association has issued a scientific statement in Hypertension on a link between high blood pressure (BP), notably in middle age, and an increased risk of cognitive impairment in later life.
The statement, based on a review of multiple studies, attributes the link to the disruption of blood vessel structure and function leading to ischaemic damage of white matter regions, with executive function and processing speed the cognitive domains most affected, and possible promotion of Alzheimer pathology.
But the effects of hypertension treatment on cognitive function are less clear, says the writing committee, chaired by Costantino Iadecola (Weill Cornell Medical College, New York, USA). Observational studies showed a cumulative effect of hypertension on cerebrovascular damage, but evidence from randomised, double-blind clinical trials was not conclusive.
Issues contributing to this include the need for longitudinal studies spanning decades between a patient having high BP and developing cognitive problems and the lack of appropriate and uniform cognitive outcomes across studies.
The upcoming release of the results of the SPRINT-MIND trial should help provide some much needed answers, says the committee, advising that, in the meantime, “treatment of high BP in midlife and judicious use of antihypertensives in late life, taking into account cerebrovascular status and comorbidities seem justified.”
By Lucy Piper
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