Dementia and arterial hypertension (AH) belong to the key non-infectious epidemics in the 21 st century, both with a high potential to significantly deteriorate the quality of life as well as shorten the life expectation. Nowadays, we can consider it proven, that middle-aged AH predicts cognitive impairment and dementia (Alzheimer´s and vascular type) in advanced age. AH is considered an equally strong risk factor for cognitive impairment as for chronic kidney disease or atrial fibrillation. So far, the treatment options for dementia are still relatively limited. Therefore, we need to pay more attention to any intervention, that can reduce or at least slow down the development of dementia. AH is a modifiable risk factor for cardio-and cerebrovascular diseases. It is highly rational to assume that its adverse effect on cognition is amplified in the case of usual geriatric polymorbidity (commonly: atrial fibrillation, diabetes, dyslipidaemia). Antihypertensives with a higher potential to reduce the development of cognitive disorders probably include some calcium channel blockers and substances affecting the renin-angiotensin-aldosterone system. Having in mind the benefits of appropriate AH control in relation to cognition we must not forget the risks of undue blood pressure reduction. Other well-designed studies are needed for an evidence-based confirmation of the positive effect of AH control on the development of dementia and to refine the effectiveness of individual antihypertensive medicines. Ref. 30, on-line full text (Free, PDF) www.cardiologyletters.sk
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