AHA: Hypertension Associated with Cognitive Decline, Alzheimer Disease

Chronic hypertension during middle age (40-64 years) is associated with cognitive decline in later life (65-84 years), according to a new review and scientific statement from the American Heart Association.

Hypertension is a top health concern in the United States and is a well-known risk factor for age-related dementia. As the population ages, it becomes more important to understand the association between hypertension and its treatment and cognitive function.
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In an effort to bridge these gaps and offer guidance for health care providers, the American Heart Association created a panel of experts who reviewed current literature and summarized the available data.

Their analysis found that strong evidence supports a negative effect of midlife hypertension on later-life cognition, although data on the effects of later-life hypertension were inconclusive.

As for the impact of treatment, observational studies suggested a cumulative effect on cerebrovascular damage, but clinical trials were inconclusive.

The panel also found that hypertension:

  • Disrupts the structure and function of cerebral blood vessel./
  • Leads to ischemic damage of white matter regions critical for cognitive function.
  • May promote Alzheimer pathology.

“After carefully reviewing the literature, the group concluded that there were insufficient data to make evidence-based recommendations,” the statement concluded.

“However, judicious treatment of hypertension, taking into account goals of care and individual characteristics (eg, age and comorbidities), seems justified to safeguard vascular health and, as a consequence, brain health.”

—Amanda Balbi

Reference:
Iadecola C, Yaffe K, Biller J, et al; American Heart Association Council on Hypertension; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council. Impact of hypertension on cognitive function: a scientific statement from the American Heart Association [published online October 10, 2016]. Hypertension. http://dx.doi.org/10.1161/HYP.0000000000000053.