Effect of antihypertensive treatment on the behavioral consequences of elevated blood pressure.

Abstract

SUMMARY It was shown in a prior study that mildly hypertensive patients performed significantly less effectively on several sensory-perceptual, cognitive, and psychomotor tests than did matched normotensive controls. To determine whether these deficits are attributable to elevated blood pressure per se, hypertensive and control subjects were recalled for reexamination 15 months after the original tests. Results indicated that those hypertensives in whom blood pressure had been lowered with antihypertensive drugs showed significant restoration of performance scores toward the levels of normotensive subjects. Hypertensives who had not received active treatment remained deficient as compared with controls. These results indicated that behavioral deficits in mild hypertension may be reversible consequences of the effects of elevated blood pressure on the central nervous system. (Hypertension 6: 202-208, 1984) KEY WORDS • mild hypertension • effect of treatment • behavioral consequences psychological tests E SSENTIAL hypertension has been a disease of special interest to behavioral scientists for many years. Franz Alexander, 1 in his classic psychoanalytic study of hypertension, discussed the hostility/dependency conflicts that seemed to be involved in the etiology of high blood pressure. Over the past 40 years and persisting today, there have been many studies in both animals and humans directed at clarifying psychological factors that may eventuate in elevated blood pressure. Despite this research effort, the mechanisms by which personality and environmental variables are translated into chronic, fixed hypertensive disease remain unclear, as do their implications for prevention and treatment.2 " 5The role of psychological factors in the etiology of hypertension, while capturing most of the research endeavor, has not been the only interest of investigators. Over the years a smattering of reports has suggested that high blood pressure may produce some

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

“…Increasing evidences indicate that brain angiotensin II (AII) and some of its fragments, that is AII [3][4][5][6][7][8] (AIV) and AII, [3][4][5][6][7] either ageing directly or by modulation of the activity of other transmitters, are involved in cognitive processes, including learning and memory. 44,45 Although the role of the brain angiotensins in humans remains to be fully explored, experimental studies have demonstrated that intracerebroventricular administration of AII and its fragments facilitated acquisition in active conditioning trials and retention in a passive avoidance situation.…”

“…44,45 Although the role of the brain angiotensins in humans remains to be fully explored, experimental studies have demonstrated that intracerebroventricular administration of AII and its fragments facilitated acquisition in active conditioning trials and retention in a passive avoidance situation. [46][47][48] The facilitatory effects of angiotensins on memory has been connected mainly with the recently discovered AT4 receptors, which preferentially bind AIV and AII [3][4][5][6][7] and are found in brain areas distinct from those possessing AT1 and AT2 receptors (mainly in the neocortex, hippocampus, dentate gyrus, thalamus and cerebellum). [49][50][51] However, considerable evidence suggests significant, although different, involvement of AT1 and AT2 receptors in cognitive processes.…”

“…[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.…”

“…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. [22][23][24][25] Evidence from the literature suggests that antihypertensive drugs may differ in their effect on cognitive function regardless of their hypotensive action.…”

Elevated LDL-C combined with hypertension worsens subclinical vascular impairment and cognitive function

“…Importantly, the early cognitive deficit of young hypertensive individuals can be reversed with an appropriate antihypertensive therapy, as suggested by previous findings. 24,[57][58][59] The association between high BP and anxiety is supported by a large number of case-control studies, which compared either psychological symptoms in hypertensive and control subjects, or BP in patients with a variety of psychiatric disorders and controls. 60 When examining anxiety disorder, Vetere et al 61 found a higher prevalence in hypertensive individuals compared with controls.…”