Relationship of Race/Ethnicity and Blood Pressure to Change in Cognitive Function

Bohannon, Arline; Fillenbaum, Gerda G.; Pieper, Carl F.; Hanlon, Joseph T.; Blazer, Dan G.

doi:10.1046/j.1532-5415.2002.50104.x

Cited by 76 publications

(64 citation statements)

References 29 publications

(43 reference statements)

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“…41 At more advanced age, [42][43][44][45][46][47] point estimates went in the same direction but only reached significance in the normotensive Hispanic Established Populations for Epidemiologic Studies of the Elderly cohort 44 and in the Active Cognitive Training for Independent and Vital Elderly Trial. 46 Among the studies with cognitive impairment as a categorical end point (Table 2), 42,48 -61 those using a dichotomized test score 53,57 classified from 15% 53 to 50% 57 of the participants as cognitively impaired and reported positive associations with hypertension.…”

Section: Longitudinal Cohort Studiesmentioning

confidence: 85%

“…To further clarify the role of blood pressure in the pathogenesis of cognitive impairment, we performed a systematic review of the prospective studies published since 2000 until early 2006, from which we extracted or computed summary statistics. The outcome variables were either levels of or changes in single or composite cognitive scores (Table 1) [36][37][38][39][40][41][42][43][44][45][46][47] ; the incidence of cognitive dysfunction, dementia, AD, or VaD (Table 2) 42,48 -61 ; or the appearance of brain lesions in histopathologic or neuroimaging studies (Table 3). [62][63][64][65] For each of these 3 end points, we ordered the reports according to the age at enrollment.…”

Section: Longitudinal Cohort Studiesmentioning

confidence: 99%

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Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

2007

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T raditional teaching subdivides the dementia syndrome into neurodegenerative Alzheimer's disease (AD), vascular dementia (VaD), and mixed variants. In spite of the vast and continuing literature on the dichotomy between AD and VaD, new emerging concepts highlight the role of cardiovascular risk factors in the pathogenesis of AD, especially in older patients. 1,2 Hypertension is the major player in the pathogenesis of stroke, poststroke dementia, and VaD. AD is the most common cause of dementia, contributing from 45% to Ͼ75% of the cases in Asians and whites, respectively. 3 This review will focus on the role of hypertension as a reversible risk factor in the development of dementia, in particular AD. To set the stage, we will first summarize current insights in the epidemiology of AD, the pathogenesis of VaD and AD, and the association between neurodegeneration and atherosclerosis. Epidemiology of DementiaAcross 36 cross-sectional studies, the prevalence of dementia increased exponentially from 0.3% to 1.0% in subjects aged 60 to 64 years to 10% to 20% in octogenarians and to Ͼ40% in the ninth decade of life. 3 In 15 longitudinal studies, the incidence of dementia showed a similar age-related dependency with rates expressed in new cases per 1000 personyears ranging from 0.4 to 4 at 60 to 64 years to 20 to Ͼ40 at 80 to 85 years. 3 Currently, 24.3 million people have dementia with an annual worldwide incidence of 4.6 million new cases. 4

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Section: Longitudinal Cohort Studiesmentioning

confidence: 85%

Section: Longitudinal Cohort Studiesmentioning

confidence: 99%

Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

2007

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“…Longitudinal studies have therefore been suggested to be more appropriate in assessing the relationship between BP and cognitive function, but they remain time dependent. The majority of longitudinal studies demonstrated elevated BP to be associated with cognitive decline 25,31,[46][47][48][49][50][51][52][53][54][55][56][57][58] but some studies showed quadratic, J-and U-shaped relationships between BP and cognitive performance 33,45,[59][60][61] in addition to three studies showing elevated BP to be associated with improved cognitive performance 27,43,49 ( Table 2). Sample sizes ranged from 155 to 10 963 and duration of follow-up ranged from 1.5 to 30 years.…”

Section: Epidemiological Studiesmentioning

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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“…Исследования, посвященные этой проблеме, в основ-ном были сосредоточены на изучении взаимосвязи АД и когнитивных функций у больных АГ пожилого и старческо-го возраста [2][3][4][5][6][7][8][9][10]. Результаты большинства этих исследова-ний свидетельствуют о том, что наличие АГ ассоциируется со снижением когнитивных функций в данной возрастной группе [2][3][4].…”

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“…через 9 лет наблюдения чаще выявлялись нарушения управляю-щих функций. В то же время другими авторами установлена U-образная зависимость между исходным уровнем САД и наличием когнитивного снижения через 3 года [9].…”

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Hypertension and cognitive impairment: the standpoint of evidence-based medicine

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2017

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Relationship of Race/Ethnicity and Blood Pressure to Change in Cognitive Function

Cited by 76 publications

References 29 publications

Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

Less Atherosclerosis and Lower Blood Pressure for a Meaningful Life Perspective With More Brain

Cognitive function and hypertension

Hypertension and cognitive impairment: the standpoint of evidence-based medicine

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