Increased incidence of neurofibrillary tangles (NFT) in non-demented individuals with hypertension

Sparks, D. Larry; Scheff, Stephen W.; Liu, Huaichen; Landers, Teresa M.; Coyne, Carolyn M.; Hunsaker, John C.

doi:10.1016/0022-510x(95)00105-b

Cited by 196 publications

(144 citation statements)

References 54 publications

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“…A potential genetic link factor between hypertension and cognitive impairment is the apolipoprotein E allele, which has been linked to vascular risk factors, 40 coronary artery disease, 41,42 and stroke, 43 as well as Alzheimer's dementia. 44,45 In postmortem studies, 46,47 an increased ⑀4 allele frequency has been reported in subjects with hypertension or critical coronary artery disease and an increased number of senile plaques and neurofibrillary tangles in the brains of apo⑀4-positive hypertensives who were not demented. Further work is needed to explore the link between apo⑀4 and hypertension and cognitive impairment in older people.…”

Section: Results Of Cognitive Assessment Battery In Hypertensive Andmentioning

confidence: 99%

Cognitive Performance in Hypertensive and Normotensive Older Subjects

et al. 2000

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Abstract-Longitudinal studies suggest that hypertension in midlife is associated with cognitive impairment in later life.Cross-sectional studies are difficult to interpret because blood pressure can change with onset of dementia and the inclusion of subjects on treatment and with hypertensive end-organ damage can make analysis difficult. We examined cognitive performance in hypertensive and normotensive subjects without dementia or stroke Ն70 years of age. Key Words: hypertension, arterial Ⅲ blood pressure Ⅲ aging Ⅲ dementia C ognitive impairment and dementia are becoming increasingly prevalent because of demographic changes. The prevalence of dementia doubles with each 5-year age rise, from 2.8% at 70 to 74 years to 38.6% at 90 to 95 years. 1 The annual incidence of dementia in the age group 85 to 88 years is 9%. 2 Dementia incidence in a population Ͼ55 years of age was 10.7 per 1000 person-years, equating to a lifetime dementia risk for a 55-year-old woman of 0.33 and 0.16 for a man. 3 The UK population Ͼ60 years of age is projected to increase by a third by the year 2026; the population with cognitive impairment is projected to double by 2026. 4 In this context, population risk factors for the development of dementia that are potentially modifiable are important to identify. Cognitive impairment usually develops insidiously, eventually reaching a stage where it becomes clinically and functionally apparent. Studies of subjects with no or with minor cognitive impairment have shown that neuropsychological tests can predict who is likely to proceed to dementia. 5 Hypertension is common in elderly Western populations, with a prevalence of 41% for men and 54% for women 75 years of age, defined by single blood pressure (BP) reading of Ͼ160 mm Hg systolic and/or Ͼ95 mm Hg diastolic or any treatment for hypertension. 6 Epidemiological data from Framingham 7 suggested no association between BP and cognitive performance when measured concurrently; however, when data were reanalyzed the average BP over 20 years was inversely related to cognitive performance. 8 Three further studies have shown a link between midlife or later-life hypertension and subsequent cognitive impairment. 9 -11 Reasons for discrepancies between cross-sectional and longitudinal studies may include the tendency for BP levels to change with the onset of dementia, 10 the inclusion of individuals with established cerebrovascular disease in cross-sectional studies, and the effects of BP-lowering therapy on cognitive function. Except for one small study in 25 older patients with severe hypertension there are no data on cognitive function in older hypertensives where the effects of cerebrovascular disease have been excluded. 12 The hypothesis of the present study was that cognitive performance in older adults without overt cerebrovascular disease would be impaired in line with increasing BP level. We determined cognitive performance in untreated older hypertensives and normotensives without cerebrovascular disease, target organ damage, or other vascular r...

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Section: Results Of Cognitive Assessment Battery In Hypertensive Andmentioning

confidence: 99%

Cognitive Performance in Hypertensive and Normotensive Older Subjects

et al. 2000

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“…7,8 Indeed, neuropathological studies have linked atherosclerotic burden in the brain to the pathological changes of both Alzheimer's disease and vascular cognitive impairment. 9,10 Alzheimer's disease and vascular cognitive impairment are the two most common causes of cognitive impairment with the former characterized by early loss of episodic memory and the latter typically involving impairment of attention, information processing and executive function. 11 It has been suggested that decreased BP reduces mechanisms contributing to Alzheimer's disease and generalized neurodegenerative changes, which may account for improvements in impairments on memory tasks.…”

Section: Hypertension and Cognitionmentioning

confidence: 99%

Cognitive function and hypertension

2008

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The importance of lowering blood pressure (BP) in hypertensive subjects is well known but the relationship between hypertension and cognitive function is controversial. This article reviews the role of hypertension in the aetiology of cognitive impairment and the relationships between BP, cerebral perfusion and cognition. It also summarizes findings of studies addressing the effect of antihypertensive therapy and cognition. An electronic database search of MEDLINE, EMBASE and the Cochrane Library and extensive manual searching of articles were conducted to identify studies that have used objective measurements of BP and neuropsychological tests to investigate the relationship among hypertension, cognitive function and/or antihypertensive treatment. In total, 28 cross-sectional studies, 22 longitudinal studies and 8 randomized placebo-controlled trials met the inclusion criteria. Cross-sectional studies showed mixed relationships between higher BP and cognition, with many studies showing no correlation or even J-or U-shaped associations. The majority of longitudinal studies demonstrated elevated BP to be associated with cognitive decline. Randomized studies demonstrated heterogeneous and, sometimes conflicting, effects of BP lowering on cognitive function. Suggested reasons for this heterogeneity include multiple mechanisms by which hypertension affects the brain, the variety of cognitive instruments used for assessment and differences in antihypertensive treatments. Although lowering the BP is beneficial in most patients with vascular risk factors, the effects of BP reduction on cognition remain unclear. Given the predicted upswing in people with cognitive impairments, the time is right for randomized clinical trials with specific cognitive end points to examine the relationship between cognitive function and hypertension and guide practice.

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“…According to this theory, patients suffering from chronic hypertension during their midlife have a higher chance for developing AD at older age. The theory proposed by Skoog [49] was further underscored by the detection of an increased amount of senile plaques and neurofibrillary tangles in the brains of hypertensive individuals [50]. Thus, chronically high blood pressure can be considered as a condition, which increases the potential to develop dementia.…”

Section: Hypertension In Alzheimer's Diseasementioning

confidence: 99%