15-year longitudinal study of blood pressure and dementia

Skoog, Ingmar; Nilsson, Lars; Persson, G.; Lernfelt, Bodil; Landahl, Sten; Palmertz, Bo; Andreasson, L-A; Odén, Anders; Svanborg, Alvar

doi:10.1016/s0140-6736(96)90608-x

Cited by 1,524 publications

(1,079 citation statements)

References 26 publications

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“…[1][2][3] This suggests that, in addition to being a powerful risk factor for cardiovascular disease, hypertension in elderly patients increases the risk of decline in cognitive function. Active lowering of BP should prevent or reduce cognitive impairment, although not all antihypertensive agents seem to be equally effective in this regard.…”

Section: Introductionmentioning

confidence: 99%

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

et al. 2005

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The aim of this study was to compare the effects of telmisartan/hydrochlorothiazide (HCTZ) vs lisinopril/ HCTZ combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients. A total of 160 patients, 76 men and 84 women, aged 61-75 years, with sitting diastolic blood pressure (DBP) 490 mmHg and o110 mmHg and systolic blood pressure (SBP) 4140 mmHg were randomized to receive temisartan 80 mg/HCTZ 12.5 mg o.d. or lisinopril 20 mg/HCTZ 12.5 mg o.d. for 24 weeks, according to a prospective, open-label, blinded end point, parallelgroup design. At the end of a 2-week wash-out period and after 12 and 24 weeks of active treatment, 24-h noninvasive ambulatory BP monitoring (ABPM) was performed and cognitive function was evaluated through six different tests (verbal fluency, Boston naming test, word-list memory, word-list recall, wordlist recognition and Trails B). Both treatments significantly reduced ambulatory BP. However, the telmisartan/HCTZ combination produced a greater reduction in 24-h, day-time and night time ABPM values. Lisinopril/ HCTZ did not induce significant changes in any of the cognitive function test scores at any time of the study, whereas at both 12 and 24 weeks telmisartan/HCTZ significantly improved the word-list memory score ( þ 17.1 and þ 15.7%, respectively, Po0.05 vs baseline), the word-list recall score ( þ 13.5 and þ 16.9%, Po0.05) and the Trails B score (À33 and À30.5%, Po0.05). These results suggest that in elderly hypertensive patients treatment with telmisartan/HCTZ produces a slightly greater reduction in ambulatory BP than lisinopril/HCTZ combination and, unlike this latter, improves some of the components of cognitive function, particularly episodic memory and visuospatial abilities.

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Section: Introductionmentioning

confidence: 99%

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

et al. 2005

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“…[1][2][3] In this context, population risk factors for the development of dementia that are potentially modifiable are important to identify. Evidence from longitudinal studies suggested that hypertension in middle or later age is associated with subsequent cognitive impairment, [4][5][6][7][8] while cross-sectional studies yielded contrasting results. In fact, some authors reported no association between high blood pressure and cognitive impairment, 9,10 some authors found such a relationship only for subjects aged 70 years and over [11][12][13] and other authors observed that higher diastolic (DBP), but not systolic, blood pressure (SBP) values were associated with lower scores in psychometric tests in the elderly.…”

Section: Introductionmentioning

confidence: 99%

“…In fact, some authors reported no association between high blood pressure and cognitive impairment, 9,10 some authors found such a relationship only for subjects aged 70 years and over [11][12][13] and other authors observed that higher diastolic (DBP), but not systolic, blood pressure (SBP) values were associated with lower scores in psychometric tests in the elderly. 14,15 Reasons for discrepancies between longitudinal and cross-sectional studies may include the tendency for BP levels to change with the onset of dementia, 7,13 the inclusion of individuals with known cerebrovascular disease in cross-sectional studies and the effects of BP lowering therapy on cognitive function. In this regard, little consensus exists in the literature about the influence of antihypertensive drugs on the association between hypertension and cognitive performance, with some studies showing better performance on cognitive function tests in treated as compared to untreated hypertensives, 4,5,[16][17][18][19] some studies showing poorer performance 20,21 and other studies showing no difference.…”

Section: Introductionmentioning

confidence: 99%

Influence of losartan and atenolol on memory function in very elderly hypertensive patients

et al. 2003

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The aim of this study was to compare the effect of the beta-adrenergic blocker atenolol and the Angiotensin II type 1 (AT1) receptor antagonist losartan on cognitive function in very elderly hypertensive patients. A total of 120 mild to moderate essential hypertensive (DBP 490 and o105 mmHg) patients, aged 75-89 years, were studied. After a 4-week wash-out period on placebo, they were randomized to receive atenolol 50 mg or losartan 50 mg for 24 weeks according to a parallel arm design. At the end of the placebo period and of each active treatment period, BP was measured (by mercury sphygmomanometer, Korotkoff I and V) and cognitive function was evaluated through three different tests (word list memory, word list recall and word list fluency). Both atenolol and losartan were equally effective in reducing SBP (À22.1 and À23.1 mmHg, respectively, Po 0.01 vs baseline) and DBP (À10.3 and À11.2 mmHg, respectively, Po 0.01 vs baseline). Atenolol treatment did not induce significant changes in any test score, whereas losartan significantly increased the score of both the word list memory (+2.2, Po0.05 vs baseline) and the word list recall test (+2.1, Po0.05 vs baseline). The comparison between losartan and atenolol was significant (Po0.05) for both memory tests. These data suggest that in very elderly hypertensive patients, chronic AT1 receptor blockade by losartan could improve cognitive function, in particular immediate and delayed memory.

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“…Über einen Zeitraum von 5 Jahren wurden 382 im Alter von 70 Jahren nicht demente Personen verfolgt [78]. Diejenigen, die im Alter von 79-85 Jahren eine Demenz (AD oder VD) nach DSM-III-R-Kriterien [] entwickelten, wiesen zum Zeitpunk des Studienbeginns signifikant höhere systolische (im Mittel 78 mmHg) und diastolische (im Mittel 0 mmHg) BD auf.…”

Section: Longitudinal Population Study Of 70-years-old In Goteborg (1unclassified

Arterielle Hypertonie und Demenz

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2005

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Die arterielle Hypertonie ist unabhän-gig von ihrer Genese als wichtigster beeinflussbarer Risikofaktor für den Schlaganfall etabliert. Ätiologisch werden 26-49% aller Schlaganfälle auf eine arterielle Hypertonie (AH) zurückgeführt [24]. Über die Konstruktion einer einfachen ätiopa-thogenetischen Reihe AH -Schlaganfall -vaskuläre Demenz (VD) ist die AH mit dem Syndrom Demenz verknüpft. Die Demenzinzidenz nach Schlaganfall wird in der Literatur mit 6-33% angegeben [52,59]. Für den Oberbegriff VD ist eine Reihe spezifischerer Unterteilungen vorgenommen worden. Román et al. unterscheiden eine zerebrale Makroangiopathie+Demenz mit Unterkategorien "multi-infarct" und "strategic-infarct dementia" von einer zerebralen Mikroangiopathie+Demenz mit Unterkategorien "subkortikal ischämisch" und "kortikal subkortikal". Weitere Kategorien sind "ischämisch hypoperfusive VD" und "hämorrhagische VD" [7]. Ein aktueller klinisch-pragmatisch orientierter Ansatz schlägt die Unterscheidung von 3 Typen vor: "post-stroke dementia", subkortikale VD und Alzheimer+VD [86]. Als verbindender Überbegriff dient der Terminus "vascular cognitive impairment" [30,59].Aber auch für die häufigere degenerative Demenz, die Alzheimer-Demenz (AD), wird die AH zunehmend als Risikofaktor diskutiert [0, 72, 75, 79]

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15-year longitudinal study of blood pressure and dementia

Cited by 1,524 publications

References 26 publications

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

Effect of telmisartan/hydrochlorothiazide vs lisinopril/hydrochlorothiazide combination on ambulatory blood pressure and cognitive function in elderly hypertensive patients

Influence of losartan and atenolol on memory function in very elderly hypertensive patients

Arterielle Hypertonie und Demenz

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