The Association Between Hypertension and Cognitive Impairment, and the Role of Antihypertensive Medications: A Literature Review

Abstract

Vascular dementia (VD) is one of the leading causes of dementia, and hypertension is a known risk factor for VD. Hypertension treatment guidelines have previously discussed an optimal blood pressure goal to prevent further cardiovascular complications with long-term management. The treatment of hypertension can prevent stroke, kidney failure, and perhaps prevent cognitive decline as well. We reviewed studies that demonstrated an association between hypertension and cognitive impairment (CI). The role of antihypertensive medications (AHM) in preventing CI was also investigated. This topic is worth exploring as dementia has high healthcare costs and will become prominent as the population in the United States ages. We used the medical subject heading (MeSH) search strategy on Pubmed and reviewed 22 articles. The studies showed that there might be a link between hypertension, AHM, and CI. The studies did not suggest a superiority of any specific AHM class to prevent CI. Further research on optimal hypertension treatment goals to prevent cognitive impairment and dementia is recommended.

AT1 Receptors: Their Actions from Hypertension to Cognitive Impairment

“…Commonly used anti-hypertensive drugs include thiazide diuretics, calcium channel blockers (CCB), angiotensin-converting enzyme inhibitors (ACEI), angiotensin-II (Ang-II) receptor blockers (ARB), and beta blockers (BB). Among all categories, drugs that directly target the renin-angiotensin system (RAS), such as ACEI and ARB, have shown more consistent and promising ability to preserve cognitive function, and to reduce AD-associated pathological alterations in both preclinical and clinical trials [ 9 – 11 ].…”

Performance of dialysis patients on the standard and basic Arabic versions of the Montreal Cognitive Assessments

“…C ognitive impairment and dementia are common public health problems that have a huge burden on the healthcare system. 1 Patients with end-stage renal disease )ESRD( requiring dialysis are at risk for cognitive impairment [2][3][4] which can manifest in the predialysis period. 5 Studies have found the prevalence of various degrees of cognitive impairment to range from 37-80% of patients on hemodialysis, 3,4,6,7 with higher prevalence in the elderly.…”